Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004002
Report Date: 10/22/2015
Date Signed 10/22/2015 04:48:25 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:GENIUS LEARNING (PS)FACILITY NUMBER:
414004002
ADMINISTRATOR:LINDA TONG, MGR.FACILITY TYPE:
850
ADDRESS:700 PENINSULA AVENUETELEPHONE:
(650) 666-7726
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY:49CENSUS: 45DATE:
10/22/2015
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Linda Tong, Toro RoanTIME COMPLETED:
05:15 PM
NARRATIVE
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LPA conducted a case management visit today. I met with Toro Roan and Linda Tong. Today, I observed seven children napping in room #5b. Room #5b is licensed for preschool program. One child in that room is enrolled in the preschool program. A staff supervising the children does not have finger print clearance.

See next page for type A citation.

This report and rights to appeal was discussed with Licensee and must be made available to the public upon request. Notice of site visit was posted. A copy of LIC9224 was provided to Licensee during the visit today to inform parents about the Type A deficiency.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2015
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GENIUS LEARNING (PS)
FACILITY NUMBER: 414004002
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2015
Section Cited
101212(b)
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Reporting Requirements. The name of the child care center director or fully qualified teacher(s) designated to act in the director’s absence shall be reported to the Department with in 10 days of a change.

Room #5b is licensed to preschool program. After school program is using that room.
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Facility needs to correct this deficiency by due date.
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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: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2015
LIC809 (FAS) - (06/04)
Page: 3 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GENIUS LEARNING (PS)
FACILITY NUMBER: 414004002
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/23/2015
Section Cited
101170
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Criminal Record Clearance:
All staff members at the child care facility shall have finger print clerance prior to having contact with children.

Staff present in room #5b supervising 7 children does not have finger print clearance. Civil penalty of $100 was issued today.
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Facility needs to correct this defiiency by due date.
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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: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2015
LIC809 (FAS) - (06/04)
Page: 2 of 3