Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004002
Report Date: 07/13/2016
Date Signed 07/13/2016 04:07:59 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: 44DATE:
07/13/2016
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Toro Roan and Linda TongTIME COMPLETED:
04:30 PM
NARRATIVE
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3, Licensing Program Analyst, LPA Yee met with site director, Mr. Roan for an Annual/Required visit today. The purpose of the visit was explained. LPA toured the facility with Mr. Roan. Present at the facility were 44 children and six staff members. There were 45 Heritage children on site during the visit. LPA reminded Mr. Roan that no co-mingling between the two programs (Heritage and preschool) Day-care areas: Room #1, #2, #3, #4 #5, bathroom A, bathroom E and shared play ground. Waiver for shared playground is posted. Sign in/out sheets were reviewed. Facility classrooms were ventilated properly. There were plenty of age appropriate children toys, and learning materials available for both indoor, outdoor and appear to be in good repair. Incidental medical services plan was discussed. Mr. Roan said he does not have any children that are on medication at this time. Immunization requirement was discussed. Staff has current CPR and First Aid, which expires 5/2017. Smoke detector and carbon monoxide detector were tested and working. Facility personnel summary report was reviewed and current. Staff file was reviewed.

Website: www.ccld.ca.gov. Title 22, Div 12, Chp 1.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2016
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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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: 07/13/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2016
Section Cited
101229.1c
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Sign in/out: A person who removes the child from the center during the day, and returns the child to the center the same day, shall sign the child in/out.

LPA reviewed sign in/out sheets. There were 44 children on site and only 37 children were signed in.
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Mr. Roan said he will speak to the parents regarding the sign in/out procedure and enure all parents sign in/out their children moving forward.
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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) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2016
LIC809 (FAS) - (06/04)
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