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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416248
Report Date: 09/07/2022
Date Signed: 09/08/2022 08:26:51 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/29/2022 and conducted by Evaluator Elizabeth Berumen
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220629100534
FACILITY NAME:PRIMROSE SCHOOL OF EVERGREENFACILITY NUMBER:
434416248
ADMINISTRATOR:SONALIKA CLARKFACILITY TYPE:
850
ADDRESS:3008 ABORN ROADTELEPHONE:
(408) 440-8215
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:165CENSUS: 68DATE:
09/07/2022
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Mohit PatelTIME COMPLETED:
09:15 AM
ALLEGATION(S):
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9
Staff yells at day care children
Staff is under the influence of marijuana
Staff pinched day care child
Staff use inappropriate discipline
INVESTIGATION FINDINGS:
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2
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5
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9
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Licensing Program Analyst's (LPAs) Elizabeth Berumen and Teodoro Trujillo conducted an unannounced follow up complaint investigation and met with Owner, Mohit Patel. The purpose of today's follow up complaint investigation is to deliver findings.

The investigation of the complaint allegations listed in this complaint were conducted by LPA Dung Mac. Based on the available evidence, including observations of the Facility, documents reviewed, and interviews completed for the complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are UNSUBSTANTIATED.
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022
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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