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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410816
Report Date: 10/20/2022
Date Signed: 10/21/2022 09:51:49 AM


Document Has Been Signed on 10/21/2022 09:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:STRATFORD SCHOOLFACILITY NUMBER:
434410816
ADMINISTRATOR:VIOLET SERYANIFACILITY TYPE:
850
ADDRESS:410 LLAGAS ROADTELEPHONE:
(408) 766-8801
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:85CENSUS: 55DATE:
10/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:17 AM
MET WITH:Violet SeryaniTIME COMPLETED:
11:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Other inspection. LPA met with Principal Violet Seryani and explained the reason the inspection. Present during today's inspection were 55 children and at least 7 staff.

At 10:48AM, LPA observed that children were using the restroom in Room 1. There were two staff present in the room. However, there was no staff standing by the door of the restroom where they can visual supervise children at all time. LPA observed that a staff will go to towards the bathroom then step away. LPA also observed that there was a child who was using the restroom in Room 11. The staff was sitting by the carpet, but cannot visually supervise child in the restroom.

LPA discussed with Principal Violet Seryani that supervision includes visual supervision.

As a result of this inspection, a type B citation was issued. Exit interview conducted and report was reviewed with Principal Violet Seryani. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/21/2022 09:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: STRATFORD SCHOOL
FACILITY NUMBER: 434410816

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/28/2022
Section Cited

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The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time,... Supervision shall include visual observation.
This requirement is not met as evident by:
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Based on observation, LPA observed that there were staff in the room; however, they were not always positioned where they can visual supervise children in the restrooms, which poses a potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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