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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422062
Report Date: 03/11/2024
Date Signed: 03/11/2024 05:18:28 PM

Document Has Been Signed on 03/11/2024 05:18 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PRIMROSE SCHOOL OF LIVERMOREFACILITY NUMBER:
013422062
ADMINISTRATOR:GUPTA, SHUBRAFACILITY TYPE:
830
ADDRESS:2901 LAS POSITAS RDTELEPHONE:
(925) 215-7372
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 62TOTAL ENROLLED CHILDREN: 50CENSUS: 41DATE:
03/11/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Elora BelgumTIME COMPLETED:
05:10 PM
NARRATIVE
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On 3/11/2024 at 10:50am Licensing Program Analyst (LPA) Morgan Pringle met with Assistant Director Elora Belgum for a complaint that was received against the facility. Present during LPA's visit was eleven (11) additional staff and forty-one (41) infants. Five classrooms (Toddler 1, Toddler 2, Toddler 3, Infant 1 and Infant 2) were toured for a health and safety inspection. Facility holds a license for preschool and school age as well. During LPA's visit it was found that staff qualifications were not being met.

At 10:50am LPA toured the facility for a health and safety inspection. At 11:15am LPA conducted file reviews of the staff and found that S1 and S2 do not have proof of qualifications via a transcript or teaching permit on file.

At 1:00pm LPA observed S1 alone during nap time in Toddler room 2 with eight (8) sleeping infants.
At 1:24pm LPA observed S2 alone during nap time in Toddler room 1 with five (5) sleeping infants and three (3) infants that were awake.

LPA informed Assistant Director that S1 and S2 did not have proof of qualifications on file at the facility. LPA was informed that S1 and S2 were supposed to bring the documentation, but have not done so and will soon. LPA informed Director that all staff documentation needs to be received before the staff members first day present at the facility. LPA informed Assistant Director that without proof of qualifications, S1 and S2 are considered Aides and are never to be left alone with the children in care.

Deficiency Cited During LPA's visit
  • Unqualified staff supervising children alone


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Assistant Director Elora Belgum.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2024
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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Document Has Been Signed on 03/11/2024 05:18 PM - It Cannot Be Edited


Created By: Morgan Pringle On 03/11/2024 at 03:10 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRIMROSE SCHOOL OF LIVERMORE
FACILITY NUMBER: 013422062

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2024
Section Cited
CCR
101216.1(g)

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101216.1(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center.
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Assistant Director will send LPA Pringle a statement explaining how the facility will remain in compliance as it pretains to staff qualifications moving forward no later than the due date of 3/14/2024. A copy of S1 and S2's transcript must also be sent to LPA Pringle by POC date.
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This requirement was not met as evidenced by: LPA observed two staff members S1 and S2 supervising children alone without proof of qualifications on file at the facility. This poses a potential risk to the health and safety of the children in care.
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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.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Morgan Pringle
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2024


LIC809 (FAS) - (06/04)
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