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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421388
Report Date: 03/18/2024
Date Signed: 03/18/2024 12:19:18 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/20/2024 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20240220132500
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:112CENSUS: 87DATE:
03/18/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Falguni BuddhdevTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Food Services - Staff do not provide adequate food service.
INVESTIGATION FINDINGS:
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On March 18, 2024, Licensing Program Analysts (LPA's) Lorraine Dacanay Breaux and Christina Uribe arrived to the facility unannounced to conclude an investigation into the above allegation. Upon arrival LPA was allowed in by the facility representative, Falguni Buddhdev Present during the visit were 87 pre-school children and 14 staff members (includes administrative staff).

During the course of the investigation LPA Breaux reviewed the facility menu posted at the facility, interviewed staff and observed the morning breakfast and/or snack on 2/29/24 and 3/18/24,
Based on record reviews, and interviews which were conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12) are being cited on the attached LIC9099 D. The attached Type B deficiency is being cited and must be corrected by the due date.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted, and report was reviewed with the facility representative, Falguni Buddhdev.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
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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Control Number 52-CC-20240220132500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PLEASANTON
FACILITY NUMBER: 013421388
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2024
Section Cited
CCR
101227(a)(1)(1)
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Food Services 101227(a)(1)(1) In child care centers providing meals to children, the following shall apply: (1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children…The minimum amount of food components to be served as breakfast/snacks.
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Children will be served the required foods each day during the meals. Facility representative was given CCL regulations regarding Food Services. This was discussed in detail. Facility Representative will provide: 1) review the regulation for Food Services 2) Create meal plans for the next 2 months that reflects the menu 3) ensure that the children are being feed according to the regulation. This will be mailed to LPA.
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This requirement was not met as evidenced by interview/observation: Children have not been served during morning breakfast/snack two variety items from at least two (2) food groups, the minimum quantity has not been provided. This poses a potential health risk to the Health and Safety to children in care.
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Facility Representative will email LPA:
Lorraine.Dacanay-Breaux@dss.ca.gov

Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
LIC9099 (FAS) - (06/04)
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