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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421389
Report Date: 04/27/2023
Date Signed: 04/27/2023 04:35:26 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
04/26/2023 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20230426092112
FACILITY NAME:PRIMROSE SCHOOL OF PLEASANTONFACILITY NUMBER:
013421389
ADMINISTRATOR:NICOLE CUSTINOFACILITY TYPE:
830
ADDRESS:7110 KOLL CENTER PARKWAYTELEPHONE:
(925) 600-7745
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY:35CENSUS: 27DATE:
04/27/2023
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nicole CustinoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Qualifications - Unqualified adults caring for infants.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 27, 2023, Licensing Program Analyst (LPA) Lorraine Dacanay arrived to the facility unannounced to conduct an initial investigation into the above allegations. Upon arrival LPA was allowed in by the facility representative. Present during the visit were 27 infants children and nine (9) additional staff members. LPA informed the facility representative of the reason for visit and toured the facility.

The allegation that "Unqualified adults caring for infants" has been SUBSTANTIATED.Through record reviews and interviews, LPA discovered within the infant classrooms at least 1 or more aides to maintain ratio throughout the day, aides are left alone with the infants and no direct supervision from a qualified teachers. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22, Division 12 & Chapter 1, Section 101416.5(b)(1)(A) is being cited on the attached LIC. 9099D.

A copy of the LIC 9224 has been given and explained. A copy of this report is to be given to each child's parent by the next business day and a copy of the LIC 9224 acknowledgement of receipt of licensing reports is to be signed by the parent and put in their child's file. A copy is also to be posted at the facility for 30 days. Any newly enrolled student's parents are to receive a copy of this report for one year.
As a result, and per California Code of Regulations, Title 22 Division 12, Chapter 1, Section 101416.5(b)(1)(a) cited on LIC 9099-D. This report must remain on file for three years. The director was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. Notice of Site visit was provided and must be posted for thirty days. Exit interview conducted with director, Nicole Custino.

An exit interview was conducted with the facility representative, Nicole Custino. Appeal RIghts provided.
A notice of site visit was posted and must remain posted for a period of 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
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: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
04/26/2023 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20230426092112

FACILITY NAME:PRIMROSE SCHOOL OF PLEASANTONFACILITY NUMBER:
013421389
ADMINISTRATOR:NICOLE CUSTINOFACILITY TYPE:
830
ADDRESS:7110 KOLL CENTER PARKWAYTELEPHONE:
(925) 600-7745
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY:35CENSUS: 27DATE:
04/27/2023
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nicole CustinoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Neglect/Lack of Supervision-Staff left infant unattended twice on playground.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 27, 2023, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux arrived to the facility unannounced to conduct an initial investigation into the above allegation. Upon arrival LPA was allowed in by the facility representative. Present during the visit were 27 infants children and nine (9) additional staff members. LPA informed the facility representative of the reason for visit and toured the facility.

Based on LPA Dacanay Breaux interviews, file review, and record reviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation that "staff left infant unattended twice on the playground" is to be SUBSTANTIATED. See LIC9099-D. During the visit the LPA delivered the findings to the director.

A copy of the LIC 9224 has been given and explained. A copy of this report is to be given to each child's parent by the next business day and a copy of the LIC 9224 acknowledgement of receipt of licensing reports is to be signed by the parent and put in their child's file. A copy is also to be posted at the facility for 30 days. Any newly enrolled student's parents are to receive a copy of this report for one year.
As a result, and per California Code of Regulations, Title 22 Division 12, Chapter 1, Section 101429(a)(1) cited on LIC 9099-D. This report must remain on file for three years. The director was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. Notice of Site visit was provided and must be posted for thirty days. Exit interview conducted with director, Nicole Custino.

An exit interview was conducted with the facility representative, Nicole Custino. Appeal RIghts provided.
A notice of site visit was posted and must remain posted for a period of 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
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 52-CC-20230426092112
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRIMROSE SCHOOL OF PLEASANTON
FACILITY NUMBER: 013421389
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
101229(a)(1)
1
2
3
4
5
6
7
101429(a)(1) Responsibility for Providing Care and Supervision for Infants (a) In addition to Section 101229, the following shall apply(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
1
2
3
4
5
6
7
POC by 04/28/23, a written plan of action will be submitted to Licensing detailing the steps staff will take to ensure visual supervision at all time. The director will discuss supervison and train on supervision to all staff in a meeting held on May 5th, 2023. Director will submit a written summary of the meeting agenda and signatures of all staff attended.
8
9
10
11
12
13
14
This requirement was not met as evidenced by:
Based on interviews, it was stated they are not providing 100% visual supervison at all times to children in care which poses an immediate health and safety risk to children in care.

8
9
10
11
12
13
14
THIS IS A ZERO TOLERANCE VIOLATION
AND A $500 CIVIL PENALTY IS ASSESSED TODAY AND $100 PER DAY WILL BE ASSESSED UNTIL CORRECTED.
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: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
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: 3 of 4
Control Number 52-CC-20230426092112
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRIMROSE SCHOOL OF PLEASANTON
FACILITY NUMBER: 013421389
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/11/2023
Section Cited
CCR
101416.5(b)(1)(a)
1
2
3
4
5
6
7
101616.5 Teacher-Child Ratios There shall be a ratio of one teacher to every three infants in attendance. (1) An aide as specified in Section 101216.2 may be substituted for a teacher when all of the following criteria are met: (A) A fully qualified teacher as specified in Sections 101616.2(a) and (c) is directly caring for and supervising no more than three infants; and has overall responsibility for supervising a total of no more than 12 infants, with the assistance of three aides as specified in Section 101616.5(b)(1)(B).
1
2
3
4
5
6
7
During the visit, LPA had the director place the qualified Infants teachers in the classrooms at all time. Director will write a plan to ensure staff is in the correct classrooms and within ratio. Director will complete staff files and contact LPA to review by 05/11/23.
8
9
10
11
12
13
14
This requirement is not met as LPA obsevered and files reviewed that staff was not quaified. Therefore this poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Director will email the written plan via email
Lorraine.Dacanay-Breaux@dss.ca.gov
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: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
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