GENIUS KIDS-ELK GROVE FLORIN ROAD CAMPUS(PS)

Type B citation from complaint investigation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am and met with Director Shana Nijjar regarding an Unusual Incident that took place March 7, 2023. LPA made observations and interviewed staff regarding the incident. The facility self-reported the incident to the Regional Office. Director stated they have immediately terminated after they witnessed the incident. They have conducted trainings for staff so that incidents like this do not occur in the future. The parents of the child were also informed of the incident. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee. SUPERVISORS NAME: Roxana Saravia LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023 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 FACILITY NAME: GENIUS KIDS-ELK GROVE FLORIN ROAD CAMPUS(PS) FACILITY NUMBER: 343624433 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type A 03/17/2023 Section Cited HSC 101223(a)(3) 1 2 3 4 5 6 7To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or 1 2 3 4 5 6 7Director stated that they immiediately terminated the staff and conducted training for the staff. LPA cleared the deficiency. 8 9 10 11 12 13 14withholding of shelter, clothing, medication or aids to physical functioning. This requirement has not been met by evidence: Facility self reported an incident. This is an immediate risk to the children in care. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Roxana Saravia LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am and met with Director Shana Nijjar regarding an Unusual Incident that took place March 7, 2023. LPA made observations and interviewed staff regarding the incident. The facility self-reported the incident to the Regional Office. Director stated they have immediately terminated after they witnessed the incident. They have conducted trainings for staff so that incidents like this do not occur in the future. The parents of the child were also informed of the incident. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee. SUPERVISORS NAME: Roxana Saravia LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023 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 FACILITY NAME: GENIUS KIDS-ELK GROVE FLORIN ROAD CAMPUS(PS) FACILITY NUMBER: 343624433 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 03/17/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Request Denied Type A 03/17/2023 Section Cited HSC 101223(a)(3) 1 2 3 4 5 6 7To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or 1 2 3 4 5 6 7Director stated that they immiediately terminated the staff and conducted training for the staff. LPA cleared the deficiency. 8 9 10 11 12 13 14withholding of shelter, clothing, medication or aids to physical functioning. This requirement has not been met by evidence: Facility self reported an incident. This is an immediate risk to the children in care. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Roxana Saravia LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023

Type A citation - immediate risk to health, safety, or personal rights