Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421401
Report Date: 07/19/2016
Date Signed 07/19/2016 10:17:43 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LIL GENIUS KID - FREMONT BLVD I, THEFACILITY NUMBER:
013421401
ADMINISTRATOR:DHILLON, RENNUFACILITY TYPE:
830
ADDRESS:34183 FREMONT BLVD.TELEPHONE:
(510) 713-2431
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY:12CENSUS: 1DATE:
07/19/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Shana DhillonTIME COMPLETED:
10:30 AM
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Licensing Program Analysts (LPAs) Melanie Otsuji and Mayla Mendoza arrived to the facility unannounced to conduct an Annual/Random visit. LPAs were met by Director Shana Dhillon. Present during today's visit were 2 teachers and 1 infant.

LPAs conducted a health and safety inspection. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are kept inaccessible. Storage areas for poisons are locked. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets and hand washing facilities are in safe and sanitary operating conditions. Floors are kept clean and safe. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. The areas around and under play equipment are cushioned with material that absorbs a fall. LPAs reviewed census with sign in/sign out sheet and all children present today were signed in. LPAs reviewed files of children in attendance today as well as files of staff present. The changing tables have a padded surface no less than one inch thick, with raised sides at least three inches thick and is covered. The infant napping equipment meets the requirements. On this date, it appears as if all infants have the required Needs and Services Plan. There are ample age appropriate toys that appear to be safe and in good condition. IMS was discussed. The following US Department of Justice resource was provided: http://www.ada.gov/childqanda.htm

There are no cited deficiencies on today's date. An exit interview was conducted. The Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. This report must be available for public review for 3 years. LPAs provided Notice of Site visit and Director posted visit notice in LPAs presence.
SUPERVISOR'S NAME: Zakiya AliTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (559) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
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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