073408281-6-7-2021-02-CC-LDYN-C44TAB-20210618143315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073408281
Report Date: 06/07/2021
Date Signed: 06/07/2021 01:53:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/22/2021 and conducted by Evaluator Melissa Guirit

COMPLAINT CONTROL NUMBER: 02-CC-20210322135032

FACILITY NAME:	SUPREME KIDS ACADEMY		FACILITY NUMBER:	073408281
ADMINISTRATOR:	FEY SAETEURN		FACILITY TYPE:	850
ADDRESS:	3065 RICHMOND PARKWAY		TELEPHONE:	(510) 964-4058
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94806
CAPACITY:	48	CENSUS: 23	DATE:	06/07/2021
		UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Tera Taylore		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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reporting requirements-no director on-site

INVESTIGATION FINDINGS:

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On June 7, 2021 at 1:00 PM Licensing Program Analysts (LPAs) Melissa Guirit and Melissa Domantay conducted an unannounced complaint investigation. LPAs met with owner, Tera Taylor. Present for this visit were 23 children and 4 staff members.

During the course of the investigation, LPA conducted interviews and reviewed records. LPA Guirit received screenshots from Tera showing the dates leading to former director's resignation. It has been more than 30 days without having a fully qualified director on site. LPA reminded owner about Licensing's regulations of having a fully qualified teacher substitute for the director if absent and if absent for more than that, the fully qualified teacher must meet the qualifications of a director. Records show that the individual that was designated to be in charge did not have all the qualifications for a director.

Based on this information, the allegation is found to be supported by a preponderance of the evidence, and the complaint is substantiated. The California Code of Regulations Title 22, Division 12, Chapter 1, Article 06, section 101215.1(f)(1) is being cited on the attached 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa Guirit	TELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20210322135032

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/07/2021 Section Cited CCR 101215.1(f)(1)	1 2 3 4 5 6 7	101215.1(f)When the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher... (1)If the child care center director is absent for more than 30 consecutive calendar days, the substitute director shall meet...of a director. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The owner will be given 30 days to have a fully qualified director in place (07/07/21). LPAs also reminded owner to review the CCL Regulations about reporting to licensing and about Director qualifications.
	8 9 10 11 12 13 14	Screenshots sent by the owner to LPA Guirit showing that date of when the former director had resigned. It has been more than 30 days of having no fully qualified director on-site.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 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: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa Guirit	TELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

LIC9099 (FAS) - (06/04)

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