Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004002
Report Date: 10/30/2015
Date Signed 10/30/2015 09:04:24 AM

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: 26DATE:
10/30/2015
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Toro RoanTIME COMPLETED:
09:20 AM
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LPA conducted a follow up visit today. I met with site director, 7 staff members and 26 children. There are 3 Heritage children in Heritage's classroom with a staff. The following deficiencies have been corrected.

1 ) Staff, Yi Yang now has finger print clearance.

2) Room 5b will only be used for preschool program.

Facility has been advised that preschool program and Heritage program must be separated at all time. Those two programs can not be co-mingled. Any changes in the preschool program must be notified to licensing department for an approval. Site director said he understands.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2015
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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