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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422066
Report Date: 02/12/2025
Date Signed: 02/12/2025 12:01:40 PM

Document Has Been Signed on 02/12/2025 12:01 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:
013422066
ADMINISTRATOR/
DIRECTOR:		SAMIMI, KELLYFACILITY TYPE:
830
ADDRESS:11760 DUBLIN BLVD.TELEPHONE:
(925) 828-2081
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 6DATE:
02/12/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Director, Kelly SamimiTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jyoti Saini 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. In addition to the director, two staff members were supervising six (6) infants. The facility operates Monday through Friday from 8:30 AM to 5:30 PM out of the Dolphins and Seals classrooms. The facility was inspected both indoors and outdoors today for health and safety hazards, and the following observations were made: There is a working fire alarm, a functioning carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. During today’s inspection, LPA did not observe any bodies of water. The director confirmed that there are no firearms or weapons stored on the premises. The center has age-appropriate toys and equipment. A first aid kit and a first aid backpack are available. The fire disaster drill log indicates that the last drill was conducted on 10/16/2024. The facility requires parents to provide lunch and snacks. LPA observed that all children’s food was labeled. Water bottles are refilled using a Barita jug. The facility requires parents to manually sign in and out the children. LPA reviewed the sign-in and sign-out sheets. All children's records were complete. The facility maintains an Individual Infant Sleep Plan (LIC 9227) for all infants under the age of 12 months, and all infant files contain individual needs and service plans. The classroom is equipped with a diaper-changing table, cribs, and cubbies labeled with the children’s names. All staff have a criminal record clearance on file. The opening and closing teachers have CPR and first aid certifications on file. The facility roster was reviewed, and a copy was obtained.

see next page..

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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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Document Has Been Signed on 02/12/2025 12:01 PM - It Cannot Be Edited


Created By: Jyoti Saini On 02/12/2025 at 10:45 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GENIUS KIDS
FACILITY NUMBER: 013422066

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(a)(1)
Fixtures, Furniture, Equipment and Supplies
(1) The licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. The facility's heat system is currently not functioning, resulting in a temperature of 58 degrees in the infants' classroom which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
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The facility shall repair the heating system by (POC) due date and submit proof of the repair to the Community Care Licensing Division (CCLD) by email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2025


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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: 013422066
VISIT DATE: 02/12/2025
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Criminal Record Clearance -Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Lead Testing – CCC COMPLETED TESTING

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for


drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS)
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
see next page.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
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: 013422066
VISIT DATE: 02/12/2025
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Type B deficiency is cited today.

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



Exit interview conducted and report was reviewed with the director, Kelly Samimi.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC809 (FAS) - (06/04)
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