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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408281
Report Date: 01/09/2020
Date Signed: 01/09/2020 12:00:41 PM

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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SUPREME KIDS ACADEMYFACILITY NUMBER:
073408281
ADMINISTRATOR:FEY SAETEURNFACILITY TYPE:
850
ADDRESS:3065 RICHMOND PARKWAYTELEPHONE:
(510) 964-4058
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY:48CENSUS: 29DATE:
01/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Fey SaeteurnTIME COMPLETED:
12:15 PM
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On 1/9/20 at 11am, Licensing Program Analysts (LPAs) Loretta Dyson and Mayla Mendoza arrived for an unannounced case management inspection. LPAs met with the director, Fey Saeteurn. There were 29 children and 5 additional staff members also present. The center is licensed as a preschool with a toddler option and operates in 7 classrooms, Monday-Friday 7:00am-6:00pm. An application was received by Licensing, requesting that the toddler option be changed to allow 12 toddlers, instead of 10. LPAs confirmed that there have been no changes to the program, layout or structure of the center since the last inspection. LPAs toured the facility and the measurements are as follows:

INDOORS: 2619.53 square feet = 75 children
OUTDOORS: 1780.96 square feet = 24 children
A fire clearance, for 36 preschoolers and 12 toddlers, was received from the City of Richmond Fire Department on 12/4/19.

LPAs did not observe any hazardous items, toxins or bodies of water accessible to children today.

The license will be changed effective today, to reflect that the center is licensed for 36 preschoolers and 12 toddlers. There are no deficiencies cited today. This report will remain on file for 3 years. A Notice of Site visit was provided and LPAs reminded the director to have it posted for 30 days. An exit interview was conducted with the director.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
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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