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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700604
Report Date: 10/05/2023
Date Signed: 10/05/2023 03:00:32 PM

Document Has Been Signed on 10/05/2023 03:00 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:GENIUS KIDS - PERALTA CAMPUSFACILITY NUMBER:
015700604
ADMINISTRATOR:DHILLON, RENNUFACILITY TYPE:
830
ADDRESS:2220 PERALTA BLVD.TELEPHONE:
(510) 304-1369
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 37TOTAL ENROLLED CHILDREN: 37CENSUS: 0DATE:
10/05/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Shanna NijjarTIME COMPLETED:
03:15 PM
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A Pre-Licensing Inspection was conducted on this date 10/05/2023 at 1:45PM by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant, Shanna Nijjar. An application was submitted for a NEW INFANT facility. Operating Monday through Friday from 8AM - 5:30PM. A health and safety inspection was conducted inside and outside. Measurements were taken and are as follows:

INDOORS: 1038.62 square feet = 30 children
OUTDOORS: 3056.64 square feet = 40 children

There are a total of 4 sinks and 2 toilets available for children use. The infant play yard is located on the back of the parking lot. The staff will be utilizing a buggy to transport children from the classroom to the fenced play yard. Play yard has a tarp and umbrellas for shade. Drinking water is available inside and outside by way of water dispensers and bottles brought from home. Children bring lunch and AM/PM snacks from home. Facility will have a back up supply of snacks should a child forget theirs at home. Menus are posted. Facility has a functioning carbon monoxide detector, smoke detector and fire extinguisher accessible throughout the facility. Facility utilizes an electronic sign in/out application which provides a unique identifier for each authorized representative. A paper copy is available should the application not work.

An approved Fire Clearance was received on 10/4/2023 from Fremont Fire Department for 37 infant aged children.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GENIUS KIDS - PERALTA CAMPUS
FACILITY NUMBER: 015700604
VISIT DATE: 10/05/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (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
LPA reviewed with Applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed the Applicant of the importance of checking for devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the applicant, Shanna Nijjar.

A license for 30 infant aged children, will be issued effective today 10/5/2023.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC809 (FAS) - (06/04)
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