Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414180
Report Date: 08/05/2015 12:00:00 AM
Date Signed 08/05/2015 10:42:12 AM

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 KIDS SANTA CLARAFACILITY NUMBER:
434414180
ADMINISTRATOR:TERESA GALLARDOFACILITY TYPE:
850
ADDRESS:4953 STEVENS CREEK BLVD.TELEPHONE:
(408) 431-7003
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:15CENSUS: 0DATE:
08/05/2015
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Saphna Rastogi & Teresa GallardoTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA), Mel Matos, conducted an announced prelicensing visit to the Facility today. LPA met with Sapna Rastogi, Applicant representative, and Teresa Gallardo, director, and explained the nature of today's visit to them The preschool will be utilizing two rooms and indoor play area in the building. Preschool hours will be from 9:00 AM to 12:00 PM Monday to Friday. The Facility also operates an after school program from 3:00 PM to 6:30 PM Monday to Friday during the calendar school year and all day during school breaks. The after school program is exempt from licensing since it is registered under the CA Department of Education as a Heritage Program. Sapna states that the preschool will only be in operation during the calendar school year and understands that the preschool and school age children cannot be present in the Facility at the same time. LPA toured and measured the indoor and outdoor areas of the Facility during today's visit.

INDOOR MEASUREMENTS ARE AS FOLLOWS:

Room 1: 20.833 x 15.500 = 322.911

Room 2: 26.167 x 15.500 = 405.588

Play Area: 24.417 x 11.500 = 280.795
23.333 x 6.750 = 157.497
21.500 x 15.250 = 327.875

Play Area Total: 766.167

TOTAL INDOOR SPACE: 1,494.666 sq. ft. divided by 60 = 24 preschool children.

There is 1 toilet (15) and 2 sinks (30) available for the preschool children. There is hot water available in the children's sinks that measured at less than 120 degrees F. LPA observed dispenser soap and disposable towels in the preschool bathrooms. Staff have one separate bathroom, located next to the children's bathroom, that can be utilized by sick children if necessary. Sick children will be isolated in the director's office and isolation equipment is provided. The Facility will utilize the 3 step method of soap/bleach/water for disinfecting purposes.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/05/2015):
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2015
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 KIDS SANTA CLARA
FACILITY NUMBER: 434414180
VISIT DATE: 08/05/2015
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 08/05/2015):

LPA did not observe any fireplaces or wall heaters at the Facility. Both preschool rooms have appropriate lighting. First aid supplies are stored in the Facility and are inaccessible to children. The Director has the full 15 hours of Health and Safety Training. The Facility will not administer any medications to the preschool children.

Parents will be required to provide snack for the preschool children. However, the Facility does have extra supplies on hand if needed. Disposable utensils and plates will be utilized by the Facility. LPA observed solid waste containers with tight-fitting lids in each classroom. Cleaning supplies will be stored in the janitor's closet inaccessible to children.

There are 39 chairs, 7 tables, and 24 cubbies within the Facility. There is adequate equipment, supplies, and toys for the preschool children in each room. The preschool children will not nap since the program will only be in operation from 9 AM to 12 Noon. Drinking water will be provided indoors via water cooler. There is a working telephone at the site. The phone number is 408-431-7003. The Facility will not be providing any transportation.

The Facility has no outdoor space and plans to use the Play Area as a multipurpose area for gross motor activities. A waiver request for the lack of outdoor space was submitted to LPA prior to today's visit. Sapna and Teresa understand that the maximum licensed capacity the Department can grant will be 15 preschool children since 60 square feet per child is required to compensate for the lack of outdoor space and because there is only one toilet available for the preschool children.

A review of staff records on May 18, 2015 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Sapna and Teresa of the applicable $100 civil penalty per person per day, a minimum of $100.00 to a maximum of $3000.00 per person for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children.

LPA conducted an exit interview with Sapna and Teresa prior to the conclusion of today's visit and advised them that a license for 15 preschool children will be approved upon completion of the items noted below.

1) Final approval for license has been granted by LPA's supervisor.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2015
LIC809 (FAS) - (06/04)
Page: 2 of 2