073408228-4-11-2022-02-CC-SJON-CEQVV8-20220524164551

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073408228
Report Date: 04/11/2022
Date Signed: 04/11/2022 05:30:54 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/04/2022 and conducted by Evaluator Michelle Sutton

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20220404090605

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: 9	DATE:	04/11/2022
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Makita Frontenot		TIME COMPLETED:	05:35 PM

ALLEGATION(S):

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Staff left day care children unsupervised during nap time

INVESTIGATION FINDINGS:

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On 4/11/22 at 1:40 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an Initial complaint Investigation at Lil' Genius Kid and met with Director Makita Frontenot. During the course of the investigation, LPA inspected the facility. Complaint allegation is that Staff left day care children unsupervised during nap time. LPA observed Staff 2 in the front of the school holding a child, while day care children were napping in the toddler 2 room. LPA observed staff 3 in the kitchen and staff 1 in infant room. Based on the observations through out this investigation, the preponderance of evidence standard has been met, Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20220404090605

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
	VISIT DATE: 04/11/2022

NARRATIVE

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Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be POSTED in the facility and PROVIDED to each existing parent by the end of today or next day child is in care. Report also must be PROVIDED to the parent of children who are enrolled over the next 12 months. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each
parent and kept in each child's file.

Exit interview was conducted, where this report, the deficiency and plan of correction were discussed with licensee Ying Cui.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED 30 DAYS AND APPEAL RIGHTS WERE GIVEN.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20220404090605

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 04/11/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/12/2022 Section Cited CCR 101429(a)(1)	1 2 3 4 5 6 7	101429 Responsibility for Providing Care and Supervision for Infant (a) In addition to Section 101229,[..](1)Each infant shall be constantly supervised [..] This requirement is not met as evidence by;	1 2 3 4 5 6 7	By end of POC Due Date 4/12/22 Director will submit a plan of action on how facility will ensure full supervision at all times. By end of this week all staff meeting/training will be held and a video on Supervision on CCLD website will be reviewed by all.
	8 9 10 11 12 13 14	Based on observation Staff 2 left 6 children unsupervised in daycare room while napping.This is an immediate risk to Health and Safety or Personal Rights risk to persons in care.	8 9 10 11 12 13 14	Director will submit proof of staff meeting (sign-in sheet and agenda).
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
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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: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

LIC9099 (FAS) - (06/04)

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