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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422065
Report Date: 06/05/2025
Date Signed: 06/05/2025 01:25:35 PM

Document Has Been Signed on 06/05/2025 01:25 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 KIDSFACILITY NUMBER:
013422065
ADMINISTRATOR/
DIRECTOR:		SAMIMI, KELLYFACILITY TYPE:
850
ADDRESS:11760 DUBLIN BLVD.TELEPHONE:
(925) 828-2081
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 35DATE:
06/05/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Licensee, Jigna Modi TIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Jyoti Saini visited the facility today to conduct a Case Management Inspection to process the request for a decrease in capacity and the removal of Building B from the license. LPA met with Licensee Jigna Modi.

Present during the inspection were the Licensee, the Director, and three staff members supervising 35 preschool children. The hours of operation are Monday through Friday, from 8:00 AM to 6:00 PM. The center has obtained an approved fire clearance from Dublin Fire Prevention Services.

The center will now operate a preschool program in Building A and Building C (Room #3), which is limited to 15 preschoolers. Building B, which was formerly licensed under the Preschool License, will now be used exclusively by The Heritage School. The Heritage School will utilize the building from 12:30 PM to 6:00 PM during the school year and from 8:00 AM to 6:00 PM during the summer. The Licensee understands that commingling with other children is never allowed. The Heritage children will enter Building B through the backdoor, which leads from the back parking lot. A health and safety inspection were conducted both indoors and outdoors, and the measurements are as follows:

Indoors: 2,115.37 square feet = 60 children

As the facility requested a decrease in capacity and the exclusion of Building B, its measurement of 279.6 square feet reduces the indoor space to 1,835.77 square feet, allowing a facility capacity of 52 children.

Outdoors: 5,668.74 square feet = 75 children

There are a total of 9 toilets and 7 sinks associated with the preschool license. Building A has 4 toilets and 3 sinks, while Building B has 5 toilets and 4 sinks.

see next page..

NAME OF LICENSING PROGRAM MANAGER: Wynn Norona
NAME OF LICENSING PROGRAM ANALYST: Jyoti Saini
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: 06/05/2025
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With the requested decrease in capacity, the Licensee will be utilizing 2 stalls and 1 toilet inside Building B exclusively for Heritage children. This reduces the number of toilets to 6 and sinks to 5 for the preschool license across Buildings A and B.

During today’s inspection, LPA did not observe any bodies of water. The Licensee confirmed that there are no firearms on the premises. The preschool rooms are equipped with age-appropriate materials and equipment. Lunch and snacks are provided by the parents, and the center provides snacks in case of an emergency. There is a functioning carbon monoxide detector, smoke detector, and fire extinguisher in the center.The Licensee acknowledged that all staff working at the facility have current CPR and first aid certifications.


Prior to licensure,
The Licensee shall submit a request for a waiver for the shared yard space and staggered times of yard usage for Heritage and Preschool children to the Community Care Licensing Division (CCLD). The final decision will be made at management's discretion.

There were no deficiencies cited during the inspection.

Notice of Site visit was provided and posted.

An exit interview was conducted, and report was reviewed with Jigna Modi.

NAME OF LICENSING PROGRAM MANAGER: Wynn Norona
NAME OF LICENSING PROGRAM ANALYST: Jyoti Saini
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC809 (FAS) - (06/04)
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