013422065-4-3-2024-52-CC-JSAI-D3YR24-20240403123743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422065
Report Date: 04/03/2024
Date Signed: 04/03/2024 12:37:48 PM

Document Has Been Signed on 04/03/2024 12:37 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GENIUS KIDS		FACILITY NUMBER:	013422065
ADMINISTRATOR:	SAMIMI, KELLY		FACILITY TYPE:	850
ADDRESS:	11760 DUBLIN BLVD.		TELEPHONE:	(925) 828-2081
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	60	CENSUS: 32	DATE:	04/03/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director Kelly Samimi		TIME COMPLETED:	12:40 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 Analysts (LPAs) Jyoti Saini and Randy Miranda met with director Kelly Samimi for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the Facility by the director. The licensee, Jigna Modi, arrived during the inspection. In addition to the director and licensee, 32 children and four staff are present today. The Facility operates Monday - Friday from 8:30 AM to 5:30 PM in the classrooms of the Koala, Bear, Panda, and Cubs. There are no children in the Koala classroom due to low enrollment. The licensee also holds a Heritage license and has 18 children enrolled in the Heritage program. The Heritage program uses a separate room not licensed by Community Care Licensing (CCL). The licensee understands that the children enrolled in the Heritage program are not to be commingled with children enrolled in child care licensed by CCL. The Facility was inspected indoors and outdoors today for health and safety hazards, and the following was observed. No bodies of water, firearms, or weapons are on the premises. The Center is in good condition with proper temperature and ventilation, and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. A first aid kit and a first aid backpack are available. The outdoor play area is fenced for supervision. The Facility requires children to bring their snacks and lunches daily. The children bring their water bottles, and the Facility refills them with a Brita water jug. The Center also conducts and documents fire and earthquake drills once every six months, and the logs show that drills were conducted on 2/20/2024. LPA reviewed the sign-in and out sheet. Through record review, it was found one children was not signed in ( technical Violation LIC9102) There is a working fire alarm system in the Facility. The Facility has a working smoke and a fully charged fire extinguisher, and a working telephone is available. All the Children's records reviewed were complete. All children have a record of emergency identification information on file. All staff has a criminal record clearance on file. The opening and closing staff have a current Pediatric First Aid/CPR certificate on file. Four staff members have expired Mandated reporter training on the file. The facility roster was reviewed, and a copy was obtained. See next page...

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GENIUS KIDS	FACILITY NUMBER: 013422065
	VISIT DATE: 04/03/2024

NARRATIVE

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During inspection,

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS (Incidental Medical Services) to children currently. If any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

please see attached LIC809-D for the deficiency cited and one technical violation was given.

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

Exit interview conducted and report was reviewed with the facility representative, Kelly Samimi.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/03/2024 12:37 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GENIUS KIDS	FACILITY NUMBER: 013422065
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as four of the staff members do not have a current Mandated Reporter Certificate, which poses a potential health safety or personal rights risk to persons in care.
	POC Due Date: 04/12/2024
	Plan of Correction
1 2 3 4	Licensee shall go to www.mandatedreporterca.com website and take the Child Care Providers course for Mandated Reporter training. Licensee shall email a copy of the new certificate to LPA Saini no later than the due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

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