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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422062
Report Date: 10/30/2024
Date Signed: 10/30/2024 04:08:43 PM

Document Has Been Signed on 10/30/2024 04:08 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PRIMROSE SCHOOL OF LIVERMOREFACILITY NUMBER:
013422062
ADMINISTRATOR/
DIRECTOR:		GUPTA, SHUBRAFACILITY TYPE:
830
ADDRESS:2901 LAS POSITAS RDTELEPHONE:
(925) 215-7372
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 62TOTAL ENROLLED CHILDREN: 62CENSUS: 35DATE:
10/30/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Elora BelgumTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
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On 10/30/2024 at 8:20AM Licensing Program Analyst (LPA) Jaleesa Jackson met with Director Elora Belgum for an Unannounced Annual/Required Inspection. Present for the inspection were 35 infants and 10 staff. The facility has 5 classrooms (Infant 1, Infant 2, Toddler, 1, Toddler 2, and Toddler 3). Only 4 of the classrooms (Infant 1, Infant 2, Toddler 2, and Toddler 3) were in use and were toured for a health and safety inspection. The facility operates 7:00AM – 6:00PM, Monday – Friday. The facility is dual licensed and holds a preschool (Facility #13422060) and school age (Facility #13422061) license.

The facility has age-appropriate materials in the classrooms that were observed to be clean and in good condition. During today's inspection, all toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. LPA observed that the thermostat for the classrooms were set to 66 degrees. LPA informed Director that the temperature range for classrooms is a minimum of 68 degrees to a maximum of 85 degrees. Staff adjusted the temperature to the room during inspection. Facility provides all sleeping materials that were properly stored and well maintained. All bottles and food are properly stored and labeled. The diapering areas were observed to be clean, properly cushioned, and free from any defects. There are carbon monoxide detectors, smoke detectors, and fully charged fire extinguishers on site.

The kitchen was observed to be clean and free from defects. The facility provides all food for the children. The facility post the menu at least 2 weeks in advance. All food was observed to be properly stored and labeled. All food prep areas were observed to be clean and free from hazards. All cleaning products were stored separately from food.

The outside play yard is fully fenced, clean, and free from hazards with ample amounts of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.
Continued 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PRIMROSE SCHOOL OF LIVERMORE
FACILITY NUMBER: 013422062
VISIT DATE: 10/30/2024
NARRATIVE
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LPA reviewed 5 children's files and found that staff are not signing off that infants can roll over on the Infant Sleep Plan (LIC9227) then having it signed off by their parent. LPA informed Director that staff need to sign off then have parents sign off on the form before changing the sign on their cribs. LPA reviewed 10 staff files and found 2 staff do not have the completed mandated reporter training for child care providers. LPA informed Director that the full general, child care provider, and test must be completed when renewing certificates. Staff completed the training while LPA was conducting visit. At least 1 opening and closing staff have current Pediatric CPR and First Aid. All staff working have obtained a criminal record clearance or exemption. The facility conducts disaster drills at least every 6 months. The last drill was logged on 9/19/2024. All required postings are posted and made visible in the lobby of the school.

There were 3 deficiencies cited on today's inspection. See 809-D for deficiencies.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.


Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PRIMROSE SCHOOL OF LIVERMORE
FACILITY NUMBER: 013422062
VISIT DATE: 10/30/2024
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative Elora Belgum.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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Document Has Been Signed on 10/30/2024 04:08 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 10/30/2024 at 02:46 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: 10/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(a)(1)
Fixtures, Furniture, Equipment and Supplies
(1) The licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in having the all classrooms set to 66 degrees which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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Director will submit a signed and dated statement acknowledging the temperture in rooms that children occupy should be. Director will submit statement to LPA by email by POC dated 11/8/2024.
Type B
Section Cited
CCR
101430(a)(3)(A)(4)
Infant Care Activities
(A) Staff shall place infants up to 12-months of age on their backs for sleeping. (4) Infants with an Individual Infant Sleeping Plan [LIC 9227 (3/20)] that have Section C of the form completed and signed by an authorized representative shall be placed on their back when first laid down to sleep. In the event the infant changes position, the infant may remain in the alternative position.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in staff have not been signing off on LIC9227 and providing it to be signed by the child's parent which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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Director will have teacher sign off of the LIC9227 for the child under 12 months old with the missing signaturea and have the parent sign off as well. Proof will be sent to LPA by email by POC date 11/8/2024.
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:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2024


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Document Has Been Signed on 10/30/2024 04:08 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 10/30/2024 at 02:46 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: 10/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 staff did not complete the full mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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Director will submit the completed training for the 2 staff members with incomplete training to LPA by email by POC date 11/8/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2024


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