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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413900
Report Date: 11/09/2022
Date Signed: 11/09/2022 07:00:39 PM

Document Has Been Signed on 11/09/2022 07:00 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) 782-2611
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 13DATE:
11/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Kamal GillTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Other. LPA met with Licensee Kamal Gill and explained the reason for the inspection. Present during today's inspection were 13 infants and at least 5 staff.

During today's inspection, LPA observed that S-1 and S-2 were with the infant children. S-1 and S-2 have fingerprint clearance and are associated to the preschool license #434413902, but not to this facility. Assistant Director submitted LIC 9182 with a valid ID for S-1 to the San Jose Regional office during today's inspection.

As a result of this inspection, a type B deficiency was issued. A civil penalty of $200 was assessed for caregiver background check. Exit interview conducted and report was reviewed with Licensee Kamal Gill. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2022
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 11/09/2022 07:00 PM - It Cannot Be Edited


Created By: Samantha Yip On 11/09/2022 at 04:18 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: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/10/2022
Section Cited
CCR
101170(e)(2)

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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f)...
This requirement is not met as evident by:
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Assistant Director submitted LIC 9182 with a valid ID for S-1 during inspection to the San Jose Regional office.
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Based on record reviews, S-1 and S-1 have fingerprint clearances and are associated to preschool license, which poses a potential health and safety risk to children in care.
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Licensee will check with licensing to ensure that S-1 and S-2's fingerprints were transferred.

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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: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022


LIC809 (FAS) - (06/04)
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