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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421388
Report Date: 10/15/2024
Date Signed: 10/15/2024 02:43:40 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
08/29/2024 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20240829091730
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: 68DATE:
10/15/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Falguni BuddhdevTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Personal Rights - Staff member hit child during nap time.
INVESTIGATION FINDINGS:
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***THIS IS AN AMENDED REPORT***

On October 15, 2024, at approximately 12:30 PM, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an unannounced subsequent complaint visit to deliver the change in the final complaint findings. LPA met with Assistant Director, Falguni Buddhdev and informed her the nature of the visit. Present at the time of inspection were 68 toddler/preschool age children and 13 additional fingerprint cleared staff.
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During the course of the investigation, LPA conducted interviews, and reviewed records. LPA reviewed the LIC 624 (dated 09/05/2024). After reviewing the LIC 624, LPA noted per facility representative, "child may have resulted in getting a pat on the bottom ....that may have been bit too hard". Therefore, the above allegation, is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 6, Section 101223(a)(3) – Personal Rights is being cited on the attached LIC 9099-D.

Notice of Site Visit was given and must be posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the assistant director, Falguni Buddhdev.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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-20240829091730
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: 10/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2024
Section Cited
CCR
101223(a)(3)
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101223(a)(3)Personal Rights (a)The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment infliction of pain, humiliation, intimidation...or other actions of a punitive nature including but not limited to: interference with functions of daily living including... sleeping... aids to physical functioning. This requirement was not met as evidence by:

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Effective 08/30/24, Facility terminated the S4.

Facility representative/director will provide training on personal rights as it pertains to nap/sleep time. Director will email the LPA the staff agenda and sign in sheet of the staff by November 15, 2024.
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Based on interviews and record review the facility stated that there was an incident occurred on 08/26/2024 where teacher/staff acknowledged that teacher "patted on the bottom a child a bit too hard" which poses a potential risk to the health and safety to children in care.
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Facility representative/Director will email to LPA at:
Lorraine.Dacanay-Breaux@dss.ca.gov
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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: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
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