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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622469
Report Date: 01/17/2023
Date Signed: 01/17/2023 12:14:06 PM


Document Has Been Signed on 01/17/2023 12:14 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:GENIUS KIDSFACILITY NUMBER:
343622469
ADMINISTRATOR:GARCIA, VANESSAFACILITY TYPE:
830
ADDRESS:2740 LA LOMA DRIVETELEPHONE:
(916) 363-2800
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:38CENSUS: 9DATE:
01/17/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Fant, TianiTIME COMPLETED:
12:30 PM
NARRATIVE
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On January 17, 2023, at approximately 9:00 AM Licensing Program Analysts (LPAs) Alize Tillery and Karyn Guerra met with Director Tiani Fant to conduct an unannounced case management inspection. During today's inspection there were 9 children being supervised by 3 teachers. The purpose of today's inspection was to create a plan of correction following reports of lead exceedance in two of the facility outlets.

On 12/7/2022, the facility tested water samples for lead. The Lead Testing identified two water outlets that have a Lead Exceedance over the amount of 5.5ppb. The two water outlets sampled are marked H and F. H has an exeedance of 10.5ppb and F with an exceedance of 8.5ppb.

Director will provide LPA Tillery with the facility sketch that includes the labeled outlets. LPA will return to clear the deficiency.

Deficiency is cited on the following LIC809-D and the plan of correction was reviewed with the Director, Tiani Fant. A copy of this report and appeal rights were provided to the Director.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize TilleryTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023
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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Document Has Been Signed on 01/17/2023 12:14 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833


FACILITY NAME: GENIUS KIDS
FACILITY NUMBER: 343622469

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2023
Section Cited

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101700.3 ...Lead Action Level... (b) ...(1) If testing indicates an Action Level Exceedance at any water outlet, the water... is deemed not safe to drink and an immediate response... shall be required.
This requirement was not met as evidenced by
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Outlets have been replaced and retested on 1/11/2023. LPA will follow up with Director on results.
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Based on record review the facility did not comply with the above regulation as the lead action level was exceeded in two water outlets, which poses Health, Safety, or Personal Rights risk to persons in care.
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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: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize TilleryTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2