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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416250
Report Date: 02/19/2026
Date Signed: 02/19/2026 04:53:58 PM

Document Has Been Signed on 02/19/2026 04:53 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PRIMROSE SCHOOL OF EVERGREENFACILITY NUMBER:
434416250
ADMINISTRATOR/
DIRECTOR:		GERANNY NATIVIDADFACILITY TYPE:
840
ADDRESS:3008 ABORN ROADTELEPHONE:
(408) 440-8215
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 22TOTAL ENROLLED CHILDREN: 21CENSUS: 15DATE:
02/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Geranny NatividadTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 02/19/2026, Licensing Program Analyst (LPA) Farida Raja conducted an unannounced annual/ random inspection in the School Age Program. LPA met with Director, Geranny Natividad, Assistant Director, Anna Yin and Owners, Mohit and Bejal Patel and explained the purpose of the today's inspection. The facility is licensed to serve 22 children ages 5-12 years in one classroom (Explorers). Preschool (#434416248) and infant license (#434416249) are on the same premises. LPA observed the required posted materials in the lobby and Emergency Disaster Plan, Dietary Restrictions and Allergy List and daily activity schedule is observed in the classroom. Days and hours of operation are Monday through Friday, 2:00 PM to 6:00 PM during school days and 6:30 AM to 6:30 PM during spring and summer camp. Facility has one active waiver to share outdoor yard 'C' between the school age and preschool programs at different times.

Children were attending a full day spring camp during today's inspection. LPA observed 9 children and 1 staff which is within the ratio requirements for school age children. LPA obtained a copy of the Personnel Report (LIC 500) for the school age component.

LPA reviewed the sign in/out logs, childcare facility roster and fire drill log. Upon review of sign in and out logs, LPA observed that authorized representatives are not signing children in and out of the center or not signing in and out with full legal signatures. The last fire drill was conducted on February 02, 2026 which is compliant with the six-month requirement for facilities. LPA observed fire extinguishers and facility has a built-in smoke detector/ fire system.

Classroom, children's restrooms, staff restrooms, kitchen and office area were inspected. There is a working telephone in the facility. Children were observed to be engaged in table activities under supervision from staff. Facility has central heating/cooling and ventilation for comfort of children.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN
FACILITY NUMBER: 434416250
VISIT DATE: 02/19/2026
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Director states that there are no weapons or firearms on the premises. Disinfectants, cleaning products and first aid supplies were stored inaccessible to the children in high cabinets. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Floors were clean and free from tripping hazards. LPA observed solid waste container with tight-fitting lid in the room. Toilets were observed to be safe, sanitary, and in working condition. Staff has two separate bathrooms that can be utilized by sick children if needed. Director stated that the facility is cleaned by staff during the day and by a cleaning service at the end of each day.

Drinking water is readily available for children indoors and outdoors via water bottles and refilled using a water pitcher. Water pitchers/coolers are used to refill bottles in the outdoor area.Water lead testing was completed for the facility on 04/28/2023 and no Action Level Exceedances were reported.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Facility provides two snacks to school age children during school days and breakfast, lunch and snacks during camp days. Menu was observed to be posted. Food and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary. All food and beverages that require refrigeration are stored in covered containers. Food allergies or dietary restrictions, were observed posted in each classroom and in the kitchen. Director stated that they use the Procare app to update parents in real time regarding their child's day.

The outdoor area of the facility was inspected and observed to be fenced in. Playground is age appropriate and free of hazards. There were no bodies of water observed.

Three children's files were reviewed during today's inspection. All children's files were complete with required documentation.

One staff file was reviewed and observed to be complete with the required transcripts/verification of experience, current Mandated Reporter Training and immunization's for pertussis, measles and statement declining influenza. At least one staff member on site has a current CPR and First Aid certification. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN
FACILITY NUMBER: 434416250
VISIT DATE: 02/19/2026
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Director stated that facility does not currently have children who require medications or Incidental Medical Services (IMS). Any medications at the facility are stored in a refrigerator in the front lobby or director's office and are inaccessible to children in care. Isolation of sick child was discussed, and sick children will be isolated in the director's office and isolation equipment will be provided. Child is always under visual supervision while in care of the facility. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility provides transportation to school age children. LPA reminded Director that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system. Children are signed in by staff when they are picked up from school. Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

One Type B deficiency was cited as a result of today's inspection. Appeal Rights provided.

Exit interview conducted and report was reviewed with Director, Geranny Natividad, Assistant Director, Anna Yin and Owner, Mohit Patel

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/19/2026 04:53 PM - It Cannot Be Edited


Created By: Farida Raja On 02/19/2026 at 01:42 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN
FACILITY NUMBER: 434416250

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Upon review of sign in and out logs, LPA observed that authorized representatives are not signing children in and out of the center or not signing in and out with full legal signatures.
POC Due Date: 03/06/2026
Plan of Correction
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Director to submit a written plan of correction to LPA by due date of 03/06/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2026


LIC809 (FAS) - (06/04)
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