343609384-9-7-2022-53-CC-SMAY-CJ2QNL-20220907121920

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343609384
Report Date: 09/07/2022
Date Signed: 09/07/2022 12:19:29 PM

Document Has Been Signed on 09/07/2022 12:19 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	CHAMPIONS @ EDNA BATEY ELEMENTARY		FACILITY NUMBER:	343609384
ADMINISTRATOR:	KIRSCH, ANGELA		FACILITY TYPE:	840
ADDRESS:	9421 STONEBROOK DRIVE		TELEPHONE:	(916) 714-0110
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	93	CENSUS: 9	DATE:	09/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Kim Brassy		TIME COMPLETED:	12:30 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	Licensing Program Analysts (LPAs) Salene Mayberry and Alecia Sifuentes met with Director Kim Brassy for the purpose of an unannounced annual inspection. Upon arrival, there were 2 staff and 9 children present. Facility hours of operation are Monday through Friday from 7:00 am to 5:30 pm. LPAs verified that all fees were current. All staff present during today's inspection have a fingerprint clearance. Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPAs toured classrooms, restrooms, and outdoor play areas. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Director stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Furniture and equipment are in good condition. All food was protected against contamination ad stored appropriately. Storage containers with solid waste have tight-fitting covers. Program provides morning snack and afternoon snack. Menus were posted. Drinking water was readily available to children both indoors and outdoors. LPAs observed full legal signatures while reviewing the sign in and sign out sheets. LPAs reviewed 10 children and 2 staff files. LPAs observed health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid (expiration 8/25/23). Report continues on LIC809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CHAMPIONS @ EDNA BATEY ELEMENTARY	FACILITY NUMBER: 343609384
	VISIT DATE: 09/07/2022

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

LPAs observed AB1207 mandated reporter training certificates for all staff. Director was reminded that staff must renew this certification every 2 years through the www.mandatedreporterca.com website.

LPAs discussed Lead Water Testing, and provided a link to the DSS website with additional information https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

Incidental Medical Services was discussed. There are currently no children enrolled that require IMS. Director is aware that when any IMS is provided, a Plan of Operation must be submitted to the Licensing. LPAs also advised that information regarding ADA can be located by calling: US Department of Justice’s toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY). Commonly Asked Questions about Child Care Centers and the ADA, is available at: http://www.ada.gov/childqanda.htm.

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. Finally, Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

An Exit interview was conducted, and the report was reviewed and provided to Director. LPAs posted the Notice of Site Visit and Director acknowledges it must remain posted for 30 days. A Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2