434414478-5-8-2019-07-CC-SYIP-BBZ2D4-20190508171741

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414478
Report Date: 05/08/2019
Date Signed: 05/08/2019 05:17:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	GENIUS KIDS		FACILITY NUMBER:	434414478
ADMINISTRATOR:	ANDREA KERN		FACILITY TYPE:	850
ADDRESS:	7132 SANTA TERESA BOULEVARD		TELEPHONE:	(408) 771-3403
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95139
CAPACITY:	81	CENSUS: 15	DATE:	05/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:34 PM
MET WITH:	Andrea Kern		TIME COMPLETED:	04:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced annual random inspection. Upon arrival, LPA met with Jatin Sangharaika, Office Administrator. Director Andrea Kern arrived shortly after. Present during the inspection were 15 preschool children and 5 staff. Facility also has a after-school program on site which is part of the Heritage School. License, Emergency Disaster Plan, and Notification of Parent's Rights were posted. Facility uses electronic sign in/out. LPA reviewed sign in/out. LPA toured the inside and outside of the facility with Director. The facility was observed to be clean, sanitary and in good repair. LPA observed restroom for children's use. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible to children. The furniture and the equipment, such as tables and chair were age-appropriate and in good condition; free of sharp or loose, or pointed parts. Storage containers for waste have tight fitted lids. Director stated that there are no weapons stored on the premise. LPA observed a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. The last fire drill was conducted on 04/10/2019. The outdoor activity area is fenced. The playground equipment outside were maintained in safe condition, free of sharp, loose or pointed parts. Areas around play structures were cushioned with resilient materials to absorbs falls. Shaded rest areas are provided through trees. LPA did not observe any bodies of water. Facility has a waiver to share outdoor space with Heritage school. LPA observed waiver to be posted; along with the outdoor schedule for both preschool and the Heritage school. Facility also has a waiver for capacity for outdoor space, which was observed to be posted.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GENIUS KIDS	FACILITY NUMBER: 434414478
	VISIT DATE: 05/08/2019

NARRATIVE

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Director stated that she currently does have children in care who requires Incidental Medical Services (IMS) services. Medication is properly stored where it is out of the reach of children. LPA observed that C-1's authorized representative filled out a form stating to give permission to facility to administer medication, but did not sign the form. Director stated that she will have parent's sign the form and keep it in file.
For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online Licensing Forms, Adoption of new Laws, etc.

In the areas evaluated during today's inspection, no deficiencies were cited as a result of today's inspection. An exit interview was conducted, where this report was discussed with Director.

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GENIUS KIDS	FACILITY NUMBER: 434414478
	VISIT DATE: 05/08/2019

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All food and snacks are prepared and brought from home. Facility does have back-up food for children. Drinking water is provided through individual water bottles.

Facility roster was reviewed and a copy was obtained. 7 children’s files were reviewed during today’s inspection. The records reviewed include but not limited to admission agreement and immunization.

4 staff files were also reviewed. There is currently at least one staff on site with valid CPR/First Aid, which expires 04/2020. Director stated they are aware that they needs to be at least one staff with current CPR/First Aid training at all time. The records reviewed include but not limited to immunization (Measles, Pertussis, and Influenza), Mandated Reporter Training (AB 1207), and education credit. Director stated that she will ensure that all staff have immunization records for Measles, Pertussis and influenza. Director also stated that she will ensure that all staff have completed Mandated Reporter Training and have record of completion in file.

LPA reviewed facility personnel report summary printed on 05/06/2019 and observed that S-1 was not on summary. S-1 is fingerprint cleared. Facility submitted LIC 9182: Criminal Background Clearance Transfer Request for S-1 on 11/05/2018. LPA obtained LIC 9182 for S-1 during inspection to transfer S-1's fingerprint clearance to facility. All other staff present during the inspection have cleared criminal record and child abuse index clearance. LPA also reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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