376701101-4-29-2021-51-CC-GCUS-C2JVDV-20210429162124

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701101
Report Date: 04/29/2021
Date Signed: 04/29/2021 04:22:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	KCE CHAMPIONS LLC @ HEARST ELEMENTARY		FACILITY NUMBER:	376701101
ADMINISTRATOR:	ALMA MEJIA		FACILITY TYPE:	840
ADDRESS:	6230 DEL CERRO BOULEVARD		TELEPHONE:	(916) 387-5761
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92120
CAPACITY:	168	CENSUS: 36	DATE:	04/29/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Madison Waller		TIME COMPLETED:	04:30 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	Covid-19 State of Emergency On April 29, 2021 at 2:50 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management virtual inspection (via Facetime) with Lead Teacher Madison Waller. Director Alma Mejia was not present at the time of inspection. The purpose of this visit is to inspect the additional rooms that the facility has requested to add to it's license. LPA virtually toured all classrooms to ensure the facility is safe for the care and supervision of children. There were 36 children present with 3 staff members. Appropriate ratios were observed. Staff members have the required background clearances and are associated to the facility. The facility is currently licensed to operate in rooms #1, #8, #9, Cafeteria, Auditorium, Art Corp Room and Library. The facility has requested to add rooms K1, B5, B8 and B9 to the license. The fire clearance for the additional rooms was granted on 4/20/21. The licensed capacity will remain unchanged at 168 children, ages 5-12 years old. The classrooms are used as elementary school classrooms during the day. Per Health and Safety Code Sections 1596.806(a), (a)(1), (a)(2) and (d) this program is exempt from square footage requirements. LPA inspected Rooms K1, B5, B8 and B9. There are sinks with drinking fountains in each classroom. Drinking water is readily accessible via water jugs. Age-appropriate supplies and equipment were observed available in the indoor activity space. There are several restrooms for the children which include toilets and sinks and afford privacy. There is a separate staff restroom. Children will be escorted to/from the restrooms at all times. Check-in will take place outside at the lunch tables. If child(ren) become ill during the day, they will be placed in the isolation area which is located in the Art Corp Room. Children’s authorized representative will be contacted immediately for pick up. Food preparation for snacks will be done in the cafeteria. The children eat snack at the outside lunch tables.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KCE CHAMPIONS LLC @ HEARST ELEMENTARY	FACILITY NUMBER: 376701101
	VISIT DATE: 04/29/2021

NARRATIVE

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There is an operational carbon monoxide detector located in the Auditorium and Cafeteria. Cleaning supplies and other toxics are inaccessible to children through latches, locks and/or placed on high surfaces. The playground to be used is the elementary school playground, which has age-appropriate play equipment and plenty of space and fencing. Water bottle refill stations are located outside on the playground and next to the lunch tables. Children have exclusive use of the playground before and after school. There is shade available. Ms. Waller was reminded to keep anything that reads, “Keep Out of Reach of Children” inaccessible to children. The facility will comply with the recommendations of the Department, as well as Department of Public Health regarding the COVID-19 pandemic.

No deficiencies are cited.

Rooms K1, B5, B8 and B9 were inspected today and are observed to be in compliance with Title 22 regulations. The addition of rooms K1, B5, B8 and B9 for childcare is granted and effective today's date, 4/29/21. The licensed rooms are as follows: rooms #1, #8, #9, Cafeteria, Auditorium, Art Corp Room, Library, K1, B5, B8 and B9. An updated license will be sent for posting.

An exit interview was conducted and appeal rights (LIC 9058 1/16) were discussed with Lead Teacher Madison Waller. A copy of this report as well as a copy of the appeal rights were emailed to Ms. Waller at the conclusion of the inspection. Ms. Waller will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021

LIC809 (FAS) - (06/04)

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