073408281-2-7-2025-02-CC-ILOA-DDNTBD-20250207133458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408281
Report Date: 02/07/2025
Date Signed: 02/07/2025 01:35:15 PM

Document Has Been Signed on 02/07/2025 01:35 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	SUPREME KIDS ACADEMY		FACILITY NUMBER:	073408281
ADMINISTRATOR/ DIRECTOR:	HIDY MADDOX		FACILITY TYPE:	850
ADDRESS:	3065 RICHMOND PARKWAY		TELEPHONE:	(510) 964-4058
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94806
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 45	DATE:	02/07/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Hidy Maddox		TIME VISIT/ INSPECTION COMPLETED:	01:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On February 7, 2025 Licensing Program Analyst (LPA) Indira Loza met with Director Hidy Maddox for an unannounced Annual/Random inspection. Present during today's inspection were 45 preschoolers and 8 fingerprint cleared staff. The teacher/child ratio was being met today. The center was toured for a health and safety check. This center operates Monday through Friday 7am to 6pm. CLASSROOMS: The preschool operates out of four classrooms. There is adequate heating/air conditioning, ventilation, and lighting. There were no cleaning supplies or toxic items accessible to children. The toys appear to be safe and well maintained. There were play and learning materials available for the children and each classroom had plenty of age appropriate activities. The furniture and equipment are age appropriate and in good repair. There is proper individual storage space for each child. The center is equipped with combined smoke and carbon monoxide detectors, telephone, and pull down fire alarm system - all were in working order. There are multiple fully charged 2A10BC fire extinguishers throughout the facility. FOOD SERVICE AREAS: The center provides Breakfast, Lunch, and one afternoon snack to the children. There are menus posted. Water is provided to the children from water jugs which are filled with tap water. OUTDOOR PLAY AREAS: The play yard is fully fenced in and has plenty of age appropriate activities and shade for the children in care. There is space for the children to run and develop their gross motor skills. There are no bodies of water or pools on the daycare premises. The play yard is free of hazards, such as holes, broken glass, and other debris. The play structures were anchored and had cushioning material underneath to absorb any falls.

Mayla Mendoza	TELEPHONE: (510) 292-9724
Indira Loza	TELEPHONE: 510-368-3672
	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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 5

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SUPREME KIDS ACADEMY	FACILITY NUMBER: 073408281
	VISIT DATE: 02/07/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

BATHROOMS: The center has separate bathrooms designated for staff and children. There are four (4) Toilets and four (4) faucets available for the children to use, they are appropriately sized for the children, and all are in safe, sanitary, and operating condition.
RECORDS: LPA reviewed 5 children files and 10 staff files. All children files reviewed were complete. All individuals subject to criminal record review have a criminal record clearance. All required documents are posted for public review. There are multiple staff members with current CPR certification during all hours of the day. A physical census of the children was taken and cross referenced with the sign-in and out log. All children were accounted for and properly signed in. The center is up to date with the disaster drills - the last drill was conducted on 2/7/25.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone or fax. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director was informed of the MyChildCarePlan.org website; 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.

This facility is currently providing Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

LIC809 (FAS) - (06/04)

Page: 2 of 5

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SUPREME KIDS ACADEMY	FACILITY NUMBER: 073408281
	VISIT DATE: 02/07/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

PIN 22-02-CCP 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
CCC COMPLETED TESTING AND NO EXCEEDANCES WERE FOUND. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

There were no citations issued during today's visit.

Exit interview conducted.
Report and appeal rights was reviewed with Director Hidy Maddox.
Notice of Site Visit provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5