435700793-5-26-2026-52-CC-CCHS-DUXQSH-20260611122530

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435700793
Report Date: 05/26/2026
Date Signed: 05/26/2026 11:34:34 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/26/2026 and conducted by Evaluator Elimika Woods

COMPLAINT CONTROL NUMBER: 52-CC-20260326094315

FACILITY NAME:	STANFORD MADERA GROVE CHILDREN'S CENTER		FACILITY NUMBER:	435700793
ADMINISTRATOR:	KOSTEPEN, KIMBERLY		FACILITY TYPE:	860
ADDRESS:	751 OLMSTED ROAD		TELEPHONE:	(650) 721-6632
CITY:	STANFORD	STATE: CA	ZIP CODE:	94305
CAPACITY:	204	CENSUS: 8	DATE:	05/26/2026
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Kimberly Kostepen		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Physical Plant-Facility staff did not ensure the center was in good repair

INVESTIGATION FINDINGS:

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On May 26, 2026, at 9:45 AM, Licensing Program Analyst (LPA) Elimika Woods arrived at the facility unannounced to conclude a complaint investigation regarding the above allegation. LPA toured the facility with Director Kimberly Kostepen. Present during the visit were eight children and five staff members. The center operates Monday through Friday, from 7:00 AM to 6:30 PM.

During the course of the investigation, observations were made and interviews were conducted. LPA interviewed staff members regarding repairs and the facility’s repair process. LPA observed the ceiling in the Chickadee Room and did not noticed any visible mold; however, water stain marks were present, which appeared to be from a previous leak.

Based on interviews conducted and observations made, the allegation that facility staff did not ensure the center was maintained in good repair is deemed UNSUBSTANTIATED, meaning that although the allegation may have occurred or may be valid, there is insufficient evidence to determine whether the alleged violation occurred.

Unsubstantiated

Estimated Days of Completion: 5

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

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

LIC9099 (FAS) - (06/04)

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