376701101-3-7-2023-51-CC-MCUY-CPWPGR-20230314111844

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376701101
Report Date: 03/03/2023
Date Signed: 03/07/2023 04:02:33 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/16/2022 and conducted by Evaluator Keturah Lane

PUBLIC

COMPLAINT CONTROL NUMBER: 51-CC-20221216151516

FACILITY NAME:	KCE CHAMPIONS LLC AT HEARST ELEMENTARY		FACILITY NUMBER:	376701101
ADMINISTRATOR:	SARAH REHART		FACILITY TYPE:	840
ADDRESS:	6230 DEL CERRO BOULEVARD		TELEPHONE:	(916) 387-5761
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92120
CAPACITY:	224	CENSUS: 56	DATE:	03/03/2023
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Alma Mejia		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Personal Rights - Staff handled child in a rough manner

INVESTIGATION FINDINGS:

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THIS IS AN AMENDED REPORT: On 3/3/23 at 2:45 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced complaint visit for the complaint received on 12/19/22 for the purpose of delivering findings on the above referenced allegation. Upon arrival, LPA met with facility representative KCE area manager Alma Mejia and toured the facility. Census was 56 children in 4 classrooms with 9 staff members present. All staff are fingerprint cleared and associated to the facility.
The Department fully investigated this complaint. Based on information obtained from the facility file review, facility documents, police report and interviews with staff, children and parents of enrolled children, it is determined that a staff member (S1) handled a child in a rough manner. The allegation is valid because the preponderance of evidence has been met, therefore the above allegation is found to be SUBSTANTIATED. See Type A deficiency cited on LIC9099-D.
(continued on LIC9099-C...)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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 51-CC-20221216151516

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 AT HEARST ELEMENTARY	FACILITY NUMBER: 376701101
	VISIT DATE: 03/03/2023

NARRATIVE

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LPA Keturah Lane informed facility representative Alma Mejia that this report dated 3/3/23 documents 1 Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Keturah Lane informed the facility representative to provide a copy of this licensing report dated 3/3/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with facility representative Alma Mejia. Notice of site visit was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC9099 (FAS) - (06/04)

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Control Number 51-CC-20221216151516

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 AT HEARST ELEMENTARY	FACILITY NUMBER: 376701101
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/03/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/06/2023 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	THIS IS AN AMENDED REPORT - 101223 Personal Rights (a) the licensee shall ensure that each child is accorded the following personal rights: (3) to be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature…this requirement was not met as evidenced by…	1 2 3 4 5 6 7	Area manager stated that the immediate correction is that staff member (S1) has not been present with children at the program since 12/13/22 and is no longer working for the company since 3/6/23. All staff members and newly hired staff will undergo health and safety training including personal rights on 3/6/23. Area manager stated she will provide written agenda of the meeting along with staff attendance sign in sheet via e-mail to LPA Lane by 3/7/23. E-mail: Keturah.Lane@dss.ca.gov
	8 9 10 11 12 13 14	Based upon documents received and interviews conducted with staff, children and parents, it is determined that staff member (S1) handled a child in a rough manner which is an immediate health, safety and personal rights risk to 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.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC9099 (FAS) - (06/04)

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