<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415530
Report Date: 04/25/2024
Date Signed: 04/25/2024 12:55:14 PM

Document Has Been Signed on 04/25/2024 12:55 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BRIGHT HORIZONS AT SUNNYVALEFACILITY NUMBER:
434415530
ADMINISTRATOR/
DIRECTOR:		GITA NEZAMFARFACILITY TYPE:
850
ADDRESS:1010 SUNNYVALE-SARATOGA AVENUETELEPHONE:
(669) 216-4384
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY: 146TOTAL ENROLLED CHILDREN: 44CENSUS: 36DATE:
04/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Gita NezamfarTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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
Licensing Program Analysts (LPAs) Mandeep Kaur and Mel Matos met with Gita Nezamfar, Site Director, for an unannounced case management investigation. Purpose of today's investigation: discuss an incident report that the Facility self reported to the Department on February 23, 2024.

Gita states that the incident occurred on February 22, 2024 during rest time at 1PM in classroom 2 (age 3-4 year old). Gita states that two teachers (S1 and S2) were present in the classroom with 21 children. Gita states that one preschool teacher(S1) was sitting next to the child (C1). Gita states that child (C1) was not happy and hit preschool teacher(S1). Gita states that Preschool teacher(S1) reacted by slapping the child (C1) back on the left cheek. Gita states that there was no mark(s) left on child (C1).

Gita states that preschool teacher (S2) informed the Assistant Director, Stephanie Gates, of the incident. Gita states written statements were obtained from the two preschool teachers (S1 & S2) on February 22, 2024. Gita states that preschool teacher (S1) was put on administrative leave on February 22, 2024 and released from the employment as of February 23, 2024.

Site director, Gita Nezamfarr stated that Zoom training on social,emotional, and interaction was provided to all school staff on March 12, 2024. Copies of training materials will be emailed to LPA Kaur (facility internet access was down during today's investigation).

As a result of this investigation, LPAs conclude that a staff violated the personal rights of a preschool child as a result of the incident noted above. Therefore, one "Type A deficiency is issued today on the attached 809-D. Exit interview conducted and report was reviewed with Site Director, Gita Nezamfar and copy of appeal rights was provided. A notice of site visit has been issued and must remain posted for 30 days.

LPAs informed Site Director that this report dated 04/25/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

**Continue on 809-C**
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: BRIGHT HORIZONS AT SUNNYVALE
FACILITY NUMBER: 434415530
VISIT DATE: 04/25/2024
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
**Continuation from 809**

Assembly bill 633 was provided and discussed with Site Director. LPAs informed the Site Director to provide a copy of this licensing report dated 04/25/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), must be placed in the child's file for verification.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 04/25/2024 12:55 PM - It Cannot Be Edited


Created By: Mandeep Kaur On 04/25/2024 at 11:47 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: BRIGHT HORIZONS AT SUNNYVALE
FACILITY NUMBER: 434415530

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/26/2024
Section Cited
CCR
101223(a)(3)

1
2
3
4
5
6
7
Personal Rights: The licensee shall ensure that each child is accorded the following personal rights: (3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
1
2
3
4
5
6
7
Site director stated that the preschool teacher (S1) was terminated as a result of the incident. Site Director stated that the Zoom training on social, emotional and interaction was provided to all school staff on March 12, 2024. Site director agreed to provide the copies of training materials via email to LPA Kaur by Friday April 26, 2024.
8
9
10
11
12
13
14
This requirement was not met as evidenced by: a preschool teacher(S1) slapped one preschool child(C1) on left cheek on 02/22/24 during rest time. This poses an immediate risk to the health, safety and personal rights of children in care.
8
9
10
11
12
13
14
A copy of this licensing report dated 04/25/2024 that documents the Type A citation issued today must be provided to parents/guardians of all children currently enrolled by the next business day or the next day the child(ren) are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224) must be placed in each child's file for verification.

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:Belinda Devall
LICENSING EVALUATOR NAME:Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2024


LIC809 (FAS) - (06/04)
Page: 3 of 3