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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413902
Report Date: 10/19/2023
Date Signed: 10/19/2023 07:49:20 PM

Document Has Been Signed on 10/19/2023 07:49 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:
434413902
ADMINISTRATOR:JENNIFER KWONGFACILITY TYPE:
850
ADDRESS:174 W. MAIN AVENUETELEPHONE:
(408) 782-2636
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 86TOTAL ENROLLED CHILDREN: 86CENSUS: 67DATE:
10/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Kamal GillTIME COMPLETED:
03:15 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.

At 2:50PM, LPA observed that a child walked from the bathroom to Preschool #2. There was no staff present with the child. At 2:54PM, LPA observed that a child walked from Pre-K to the cubbies without any staff present.

As a result of this inspection, a Type A citation was issued. A civil penalty of $1000 was assessed for Immediate $500 and Repeat Violations. Exit interview conducted and report was reviewed with Licensee Kamal Gill.

LPA Samantha Yip informed Licensee Kamal Gill that this report dated 10/19/2023 document(s) one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the facility representative to provide a copy of this licensing report dated 10/19/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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 10/19/2023 07:49 PM - It Cannot Be Edited


Created By: Samantha Yip On 10/19/2023 at 03:48 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: 434413902

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/20/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time,... Supervision shall include visual observation.
This requirement is not met evidenced by:
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By POC 10/20/2023, Licensee will submit written plan how children will be supervised at all times.
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Based on observation, LPA observed at 2:50PM that a child walked from the bathroom to the classroom without any staff present and at 2:54PM, a child walked from the classroom to the cubbies without any staff present. This poses an immediate risk to the health and safety to the 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: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023


LIC809 (FAS) - (06/04)
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