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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409580
Report Date: 01/24/2024
Date Signed: 01/24/2024 04:11:08 PM

Document Has Been Signed on 01/24/2024 04:11 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:PRIMROSE SCHOOL OF DANVILLEFACILITY NUMBER:
073409580
ADMINISTRATOR:KARIM RAMZANALIFACILITY TYPE:
830
ADDRESS:2425 CAMINO TASSAJARATELEPHONE:
(925) 488-4880
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY: 9TOTAL ENROLLED CHILDREN: 9CENSUS: 26DATE:
01/24/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:Morrina JackTIME COMPLETED:
04:10 PM
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On 1/24/24 at 8:08am Licensing Program Analyst (LPA) arrived to the facility for a case management visit. LPA met with owner, assistant director and temporary designated site director. During visit LPA observed required licensing documentation to be missing: Parent's Rights Poster, Child Seat Safety Law Poster, Earthquake Preparedness Poster, Emergency Disaster Plan, Menus, Activity Schedule, Granted waivers, Sudden Infant Death Poster, and Shaken baby syndrome poster.

LPA printed the following:Parent's Rights Poster, Child Seat Safety Law Poster, Earthquake Preparedness Poster, Granted waivers, Sudden Infant Death Poster, and Shaken baby syndrome poster.

During inspection LPA checked medication storage and required documentation for medication administering. LPA observed medication to be missing required documentation. LPA did observe the appropriate storage and labeling including expiration dates for the medications.

Based upon observation and record review no deficiencies were cited today. However, LPA did discuss technical advisories with the facility assistant director, owner and temporary site director.

Exit interview conducted with Karim Ramzanali, Morrina Jack and Sareh Ostad.

A notice of site visit was provided to be posted for 30 days. Appeal Rights were provided to owner for review.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
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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