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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415146
Report Date: 05/02/2024
Date Signed: 05/03/2024 08:13:32 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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
04/15/2024 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240415135049

FACILITY NAME:PRIMROSE SCHOOL OF WILLOW GLENFACILITY NUMBER:
434415146
ADMINISTRATOR:SHANAWANY,AYAHFACILITY TYPE:
850
ADDRESS:1496 HAMILTON AVENUETELEPHONE:
(669) 273-6169
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY:174CENSUS: 133DATE:
05/02/2024
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Ayah Shanawany/ Sima ShahTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Staff do not ensure reporting requirements are followed
2. Staff do not ensure blankets are used in a safe manner during naps for children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Anna Morales conducted a Subsequent visit to deliver the findings for the above allegations. LPA met with Owner Sima Shah and Director Ayah Shanawany. LPA toured the facility, conducted observation, interviewed children, staff, and obtained copy of documents.

Based on interviews and observations, it is concluded that although the allegations noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. The allegation is UNSUBSTANTIATED.

No deficiencies were issued as a result of this inspection.
A Notice of Site Visit was given and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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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