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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422465
Report Date: 11/22/2023
Date Signed: 11/22/2023 09:52:24 AM


Document Has Been Signed on 11/22/2023 09:52 AM - 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:GENIUS KIDS - MOWRY CAMPUSFACILITY NUMBER:
013422465
ADMINISTRATOR:RENNU DHILLONFACILITY TYPE:
830
ADDRESS:3645 MOWRY AVENUETELEPHONE:
(510) 304-1369
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:28CENSUS: 13DATE:
11/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Ria DasTIME COMPLETED:
10:00 AM
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On November 22nd, 2023 at approximately 9:15am, Licensing Program Analyst (LPA) April Wright arrived for a Case Management Visit and was met by Center Administrator Ria Das. Purpose of today's visit was to issue an amended Facility Report due to an appeal decision finding.

Present during today's visit were 13 children and 6 Staff Personnel. The amended report was read and reviewed with Center Administrator Ria Das. Copies of report were given by LPA.

Notice of Site Visit was given and must be posted and remain for 30 days.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: April WrightTELEPHONE: (510) 542-4257
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2023
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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