367750003-5-8-2023-12-CC-BBEO-CRMLD5-20230508083923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367750003
Report Date: 05/05/2023
Date Signed: 05/08/2023 08:39:48 AM

Document Has Been Signed on 05/08/2023 08:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	KCE CHAMPIONS LLC @ ENDEAVOR		FACILITY NUMBER:	367750003
ADMINISTRATOR:	MURRAY, KEITH		FACILITY TYPE:	850
ADDRESS:	12403 RIDGECREST		TELEPHONE:	(442) 285-9660
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92395
CAPACITY:	30	CENSUS:	DATE:	05/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Teresa Sanchez		TIME COMPLETED:	02:30 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 Analyst (LPA) Beneroso director Teresa Sanchez, for the purpose of conducting an announced annual inspection of the School Age Center. During this inspection, LPA Beneroso toured the facility and observed 27 children present with two staff members providing care and supervision. Center is located at the Endeavor School of Exploration in the, Victorville Elementary School District. The center is currently using one room the "Project Room. The center operational hours are from Monday through Friday 6:00am to 8:00am and 2 :15pm and 6:30pm. Every Friday afternoon from 12:15 pm to 6:30 pm LPA Beneroso observed age appropriate furniture, equipment, toys and materials in the classroom. The classroom was observed to be clean, safe and free of any health or safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. LPA observed water fountains outside the classroom. Facility provides disposable cups for drinking water in the classroom. Medications are not kept in the classroom. If medications need to be stored, they will be locked storage cabinet. An emergency backpack is kept near the exit door with all the required supplies. This facility has an operational carbon monoxide detector a dual/smoke and carbon monoxide detector. There is a fire extinguisher in the classroom that is in operating condition.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KCE CHAMPIONS LLC @ ENDEAVOR	FACILITY NUMBER: 367750003
	VISIT DATE: 05/05/2023

NARRATIVE

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LPA observed a play structure/apparatus that was securely anchored to the ground. Underneath the play structure LPA observed form padding, enough cushion to absorb a fall. LPA observed water fountains in the outdoor play area. The outdoor activity space is located on a functioning public school site, therefore, the site is exempt from square-footage and fencing requirements for child care centers.

Furniture and equipment were observed to be in good condition, free of sharp, lose or pointed parts. Cleaning solutions are kept in the supply cabinet that was observed to have safety latch. LPA observed the "boys" and "girls" restroom facilities. The bathrooms are separate and located outside the project room down the hallway. Staff escorts children to and from the restrooms.

This facility serves morning snack and afternoon snack, breakfast will be provided by the cafeteria. The facility's snack menu is posted on the "blue board" that is kept at the entrance in the room. Fire extinguisher, smoke detector and carbon monoxide detector were all observed to be maintained.

The Fire/Earthquake drill logs is maintained current and up to date. Last Fire/Earthquake drill was conducted on 04/27/2023. LPA observed required licensing forms; forms were posted on a board near the door. Staff are certified in Pediatric CPR and First Aid (expires 01/29/2024).

This facility does not currently provide Incidental Medical Services – IMS. Facility does not provide transportation as part of their services. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. All records are complete with all the required forms and documents.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KCE CHAMPIONS LLC @ ENDEAVOR	FACILITY NUMBER: 367750003
	VISIT DATE: 05/05/2023

NARRATIVE

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Director was reminded that after March 30, 2018, a person who is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

Director was reminded that any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Director shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of the day care center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiency was cited today.

Exit interview conducted and report was reviewed with the Director. This report was and provided to along with her appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

LIC809 (FAS) - (06/04)

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