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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413900
Report Date: 11/16/2023
Date Signed: 11/16/2023 03:55:41 PM

Document Has Been Signed on 11/16/2023 03:55 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:GENIUS KIDSFACILITY NUMBER:
434413900
ADMINISTRATOR:JENNIFER KWONGFACILITY TYPE:
830
ADDRESS:174 W MAIN AVENUETELEPHONE:
(408) 782-2636
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 13DATE:
11/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Kamal GillTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Other inspection. LPA met with Licensee Kamal Gill and explained the reason for the inspection.

On 10/19/2023, LPA reviewed eight children's files. LPA observed that six out of 8 children did not have written permission from parent to have child enrolled in the toddler option. LPA also observed on 10/19/2023 that there were 13 toddler in one room. LPA discussed with Licensee that the maximum group size, with two teachers, or one fully qualified teacher and one aide, shall not exceed 12 toddlers.

As result of this inspection, Type B citations were issued. Exit interview conducted and report was reviewed with Licensee Kamal Gill. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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 11/16/2023 03:55 PM - It Cannot Be Edited


Created By: Samantha Yip On 11/16/2023 at 01:21 PM
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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GENIUS KIDS
FACILITY NUMBER: 434413900

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2023
Section Cited
CCR
1596.956(a)(3)

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Parents shall give permission for the placement of their children in the toddler program.
This requirement is not met as evidenced by:
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By 12/01/2023, Director stated that she will have parent sign permission and send proof to Licensing.
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Based on record review, 6 out of 8 children did not have written permission from parent to place child in the toddler program, which poses a potential health and safety risk to children in care.
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Type B
11/22/2023
Section Cited
HSC1596.956(a)(5)

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The maximum group size, with two teachers, or one fully qualified teacher and one aide, shall not exceed 12 toddlers.
This requirement is not met as evidenced by:
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By POC 11/22/2023, Licensee will submit plan how she will ensure that the group size does not exceed 12 toddlers.
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Based on observation, LPA observed on 10/19/2023 that there were three staff with 13 toddlers, which poses a potential health and safety risk to children 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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023


LIC809 (FAS) - (06/04)
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