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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421388
Report Date: 11/03/2023
Date Signed: 11/03/2023 12:03:46 PM

Document Has Been Signed on 11/03/2023 12:03 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PRIMROSE SCHOOL OF PLEASANTONFACILITY NUMBER:
013421388
ADMINISTRATOR:NICOLE CUSTINOFACILITY TYPE:
850
ADDRESS:7110 KOLL CENTER PARKWAYTELEPHONE:
(925) 600-7745
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 112TOTAL ENROLLED CHILDREN: 112CENSUS: 69DATE:
11/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Nicole Custino TIME COMPLETED:
12:30 PM
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On November 3, 2023 License Program Analysts (LPAs) Lorraine Dacanay Breaux and Brittany Crass visited for an unannounced Case management - Required/Continual Required visits/inspection. This visit is due to a non compliance meeting, facility is on required visits for one year. Present for today's visit was Director, Nicole Custino and 7 additional staff members. There were 69 preschool children in care. LPA reviewed and obtained a copy of the facility roster. A tour of the facility was completed for heath and safety inside and out. Hours of operation is Monday - Friday from 7:00 AM - 6:00 PM. This facility has a infant component facility #013421389.

LPA reminded facility representative that the facility is on required visits for one year.

A notice of site visit was provided and must remain posted for 30 days. Appeal Rights provided. Exit interview conduct with director, Nicole Custino.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2023
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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