434414131-4-27-2023-07-CC-GKUN-CSLUK3-20230608153829

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414131
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:18:57 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/24/2023 and conducted by Evaluator Pietro Hernandez

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230424141037

FACILITY NAME:	SARATOGA FRENCH CULTURAL PRESCHOOL		FACILITY NUMBER:	434414131
ADMINISTRATOR:	BOUGACHOUCH, NADIA		FACILITY TYPE:	850
ADDRESS:	12850 SARATOGA AVENUE		TELEPHONE:	(408) 740-3350
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY:	45	CENSUS: 36	DATE:	04/27/2023
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Nadia Bougachouch		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Uncleared adult on the premises.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analysts (LPAs) Pete Hernandez and Marilou Monico conducted an initial site visit to the child care facility to investigate the complaint allegation listed above as possible Title 22 deficiency. LPAs met with Director Nadia Bougachouch, and explained to her the purpose of the inspection.

LPAs conducted interviews with Nadia, 5 staff, and (S1). Copies of children's roster were obtained. During the investigation LPA's observed (S1) walking and supervising children to use the restroom and confirmed that (S1) is unfingerprinted and not associated to the Facility.

Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on the next page. Licensee/Director was informed that failure to correct the deficiency may result in further civil penalties.

Continued on page 2 of 9099A dated 4/27/2023.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 07-CC-20230424141037

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SARATOGA FRENCH CULTURAL PRESCHOOL	FACILITY NUMBER: 434414131
	VISIT DATE: 04/27/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

There is an issuance of Type A citations today, a copy of the Facility Evaluation Report LIC9099D has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in children's files.

A deficiency is being cited based on the LPAs observation and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC9099A ,A violation regarding Criminal Record Clearance warrants a civil penalty of $500 and is hereby assessed, See LIC421M. An exit interview was conducted, and Plan of Correction was reviewed and developed with the licensee. A copy of this report and appeals rights were discussed and left with the Licensee, Nadia Bougachouch, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 07-CC-20230424141037

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SARATOGA FRENCH CULTURAL PRESCHOOL	FACILITY NUMBER: 434414131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/27/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/28/2023 Section Cited CCR 101170(e)(1)	1 2 3 4 5 6 7	Criminal Record Clearance 101170(e)(1): Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption.	1 2 3 4 5 6 7	Effective immediately the Director shall ensure that S-1 will not be permitted to work prior to obtaining a criminal record clearance and being associated to the facility. To be completed by the end of the day by the POC due date 4/28/2023, the Director shall submit a written plan to Community Care Licensing outlining how the facility will ensure all staff employed by the facility are cleared and associated.
	8 9 10 11 12 13 14	This has not been met as evidenced by: Based on interviews and LPAs observation, S1 has been allowed to work in the facility prior to obtaining criminal record clearance. This presents an immediate risk to health and safety of the children in care.	8 9 10 11 12 13 14	Civil penalty of $500 was assessed.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4