Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414180
Report Date: 03/16/2017
Date Signed 03/16/2017 12:27:33 PM

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:SAPNA RASTOGIFACILITY TYPE:
850
ADDRESS:4953 STEVENS CREEK BLVD.TELEPHONE:
4084317003
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:15CENSUS: 15DATE:
03/16/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Sapna RastogiTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA), Mel Matos, conducted an unannounced annual/random inspection and increase of capacity visit to the Facility today. LPA met with Sapna Rastogi, Licensee representative/director, and explained the nature of today's visit to her. LPA toured the Facility both inside and outside during today's visit. LPA notes that the Facility is licensed in Rooms 1, 2, & indoor play areas. Preschool hours are: 9:00 AM to 12:00 PM Monday to Friday. The Facility also operates an after school program from 2:00 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: 24.667 x 19.250 (minus 38.750) = 436.089
23.333 x 6.750 = 157.497
21.500 x 15.250 = 327.875

Play Area Total: 921.461

TOTAL INDOOR SPACE: 1,649.960 sq. ft. divided by 60 = 27 preschool children.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 03/16/2017):
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2017
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GENIUS KIDS SANTA CLARA
FACILITY NUMBER: 434414180
VISIT DATE: 03/16/2017
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 03/16/2017):

LPA observed that all rooms are clean and safe for all children and staff. Sapna states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via water cooler and pitchers/disposable cups. LPA observed solid waste containers with tight-fitting lids in the Facility Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Sapna states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children.

LPA observed all furniture and equipment is in good condition and safe for the children. The Facility has no outdoor space and uses the Play Area as a multipurpose area for gross motor activities. Waiver for lack of outdoor space is already on file.

Sapna states that the Facility does not administer any medications. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies issued during today's visit. Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.cdss.ca.gov. LPA conducted an exit interview with Sapna and advised her that a license for 27 preschool children will be approved upon receipt of an updated Fire Safety Inspection Request from the Santa Clara Fire Department.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2017
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GENIUS KIDS SANTA CLARA
FACILITY NUMBER: 434414180
VISIT DATE: 03/16/2017
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 03/16/2017):

There is 2 toilets (30) and 3 sinks (45) available for the preschool children. 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.

LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), and Activity Schedule. The Facility has one active waiver on file (lack of outdoor space) and is in compliance with the conditions of the waiver.

A review of staff records on March 15, 2017 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 of the applicable civil penalties 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period.

LPA reviewed ten children's and three staff files (director, one fully qualified teacher, and one partially qualified teacher) during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All three staff files reviewed contain the required transcripts/verification of experience. Sapna and two teachers have current CPR and First Aid certifications on file. Sapna understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).

LPA observed that the teacher/child ratio was in compliance during today's visit. Sapna understands the conditions, limitations, and capacity specifications of the Facility license. Sapna understands that children shall be visually supervised at all times. LPA observed 1 fully qualified teacher and 1 partially qualified teacher with 15 preschool children in the Facility during today's visit.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 03/17/2017):
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2017
LIC809 (FAS) - (06/04)
Page: 2 of 3