<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334807508
Report Date: 03/30/2023
Date Signed: 03/30/2023 04:05:52 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/06/2023 and conducted by Evaluator Karrene Turner
COMPLAINT CONTROL NUMBER: 09-CC-20230106171520
FACILITY NAME:KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARYFACILITY NUMBER:
334807508
ADMINISTRATOR:MARI WALSHFACILITY TYPE:
840
ADDRESS:20440 RED POPPY LANETELEPHONE:
(951) 653-9477
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY:66CENSUS: 17DATE:
03/30/2023
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Desiree Padilla, Site DirectorTIME COMPLETED:
04:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Supervision - Facility was unable to locate a day care child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On March 30, 2023, Licensing Program Analyst (LPA) Kay Phillips arrived at KCE Champions @ Tomas Rivera Elementary to conclude the investigation regarding the above allegation. LPA conducted a tour of the facility and the census was taken. During the investigation interviews were conducted with pertinent parties and documentation was collected.

On January 6, 2023, a complaint was received alleging the facility was unable to locate a day care child. It was confirmed staff lost track of a child during the transition of returning to the classroom from recess. Due to staff using the name to face protocol, staff was immediately able to identify the missing child. Through staff’s quick efforts, the child was found hiding inside the classroom. Child Care Regulations 101229, Responsibility for Providing Care and Supervision states “No child shall be left without the supervision of a teacher at any time…Supervision shall include visual observation.” When speaking to the LPA, the child believed it would be funny to hide from staff and meant the incident to be a joke. However, it was determined that staff failed to have visual line of sight of the child.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 09-CC-20230106171520
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY
FACILITY NUMBER: 334807508
VISIT DATE: 03/30/2023
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
Based on all the information obtained from pertinent parties, documentation, records review during inspection, the department has determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

See LIC 9099-D for deficiencies.

Exit interview was conducted with Desiree Padilla , Program Director. A copy of this report, Notice of Site Visit, and Appeal Rights were provided A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. A copy of this report must be made available to the public for three years upon request.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 09-CC-20230106171520
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY
FACILITY NUMBER: 334807508
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/31/2023
Section Cited
CCR
101229
1
2
3
4
5
6
7
Responsiblity for Care & Supervision: No child shall be left without the supervision of a teacher at any time…Supervision shall include visual observation.
1
2
3
4
5
6
7
Licensee agrees to conduct an in-person training with staff regarding the responsiblity to provide appropriate supervision. Copies of the sign-in sheet and the agenda will be submitted, as proof, to the LPA by the POC due date.
8
9
10
11
12
13
14
This requirement was not met as evidenced by the statement of the teachers that the child could not be found, as well as the child's disclosure of entering the classroom and hiding without adult supervision. This poses an immediate risk to the health and safety to the children in care.
8
9
10
11
12
13
14
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.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5