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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422061
Report Date: 10/21/2022
Date Signed: 10/21/2022 01:46:13 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/21/2022 01:46 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PRIMROSE SCHOOL OF LIVERMOREFACILITY NUMBER:
013422061
ADMINISTRATOR:GUPTA, SHUBRAFACILITY TYPE:
840
ADDRESS:2901 LAS POSITAS RDTELEPHONE:
(925) 215-7372
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
10/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Shubra GuptaTIME COMPLETED:
02:00 PM
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On October 21, 2022, Licensing Program Analyst (LPA) Simerjit Kaur conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION and met acting site director with Shubra Gupta. Per director, currently there are no school children enrolled in school age component.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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