073408228-5-5-2022-02-CC-MPRE-CE5TEZ-20220505144045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408228
Report Date: 05/05/2022
Date Signed: 05/05/2022 02:40:49 PM

Document Has Been Signed on 05/05/2022 02:40 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	LIL' GENIUS KID, THE		FACILITY NUMBER:	073408228
ADMINISTRATOR:	YING CUI		FACILITY TYPE:	830
ADDRESS:	33 AMBROSE AVE		TELEPHONE:	(925) 709-2900
CITY:	BAY POINT	STATE: CA	ZIP CODE:	94565
CAPACITY:	30	CENSUS: 0	DATE:	05/05/2022
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ying Cui		TIME COMPLETED:	02:40 PM

NARRATIVE

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On 5/5/2022 Licensing Program Analysts (LPA's) Morgan Pringle and Michelle Sutton met with Licensee/owner Ying Cui for an Announced Case Management visit to discuss an Unusual Incident that happened at the facility on 4/13/2022 regarding a disgruntled employee. Licensee stated that the employee came to facility and was verbally abusive to her and was threatening the staff. The incident happened outside of the classroom, but children could hear the incident in the hallways.

LPA's conducted file reviews of the staff as well as an interview with the Licensee about the incident.

LPA Pringle informed licensee that this report dated 5/5/2022 document(s) one (1) Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Pringle informed the licensee to provide a copy of this licensing report dated 5/5/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Ying Cui.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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 05/05/2022 02:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LIL' GENIUS KID, THE	FACILITY NUMBER: 073408228
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/06/2022 Section Cited	1 2 3 4 5 6 7	101223(a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by: on 4/13/2022 a staff member had an altercation with the
	8 9 10 11 12 13 14	Licensee. There were children and a parent present during this incident with posed an immedite risk to the health and safety to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC809 (FAS) - (06/04)

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