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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417300
Report Date: 12/10/2024
Date Signed: 12/11/2024 09:53:15 AM

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
10/24/2024 and conducted by Evaluator Farida Raja
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20241024144325
FACILITY NAME:BELLGRAD EVERGREEN STEM ACADEMYFACILITY NUMBER:
434417300
ADMINISTRATOR:EMERALD PEOPLEFACILITY TYPE:
840
ADDRESS:3010 FOWLER ROAD, CLASSROOM 31TELEPHONE:
(408) 568-3674
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:70CENSUS: 50DATE:
12/10/2024
UNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Ronit Rose and Swetha NadamuniTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Facility operates out of ratio
INVESTIGATION FINDINGS:
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On 12/10/2024 at 2:55pm, Licensing Program Analysts (LPAs), Farida Raja anf Jaime Gonzales conducted an unannounced complaint visit to deliver investigation findings for the above allegation. LPAs met with Director, Ronit Rose and explained the purpose of today's visit. LPAs toured the indoor and outdoor areas of the facility, and observed 50 children and 4 staff within the two classrooms.

During the course of the complaint investigation, LPA interviewed owners, staff and parents. Based on interviews conducted, facility has been observed over ratio with one staff supervising over 14 children. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

Continued on Page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 07-CC-20241024144325
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: BELLGRAD EVERGREEN STEM ACADEMY
FACILITY NUMBER: 434417300
VISIT DATE: 12/10/2024
NARRATIVE
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One Type A deficiency was cited on the attached LIC 9099D page. Appeal Rights were provided to Director. LPAs informed Director, Ronit that this report dated 12/10/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Raja informed the Director, Ronit to provide a copy of this licensing report dated 12/10/2024 that documents any Type A citation 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 (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted and report was reviewed with Director, Ronit Rose and Owner, Swetha Nadamuni.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20241024144325
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: BELLGRAD EVERGREEN STEM ACADEMY
FACILITY NUMBER: 434417300
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
12/11/2024
Section Cited
CCR
101516.5(b)(1)
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101516.5 Teacher-Child Ratio (b) (1) A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children.

This requirement is not met as evidenced by:
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Director to submit a plan of correction of how facility will maintain required school age ratios at all times including back-up plans when staff call in sick, are unavailable or running late.
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Based on interviews conducted with owner, staff and parents, the facility was observed over ratio with one staff supervising more than 14 school age children. This poses an immediate risk to the health, safety and personal rights of 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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3