376701382-11-5-2019-51-CC-SSIO-BHN49R-20191105175445

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701382
Report Date: 11/05/2019
Date Signed: 11/05/2019 05:54:54 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 @ KAVOD		FACILITY NUMBER:	376701382
ADMINISTRATOR:	MARISSA LUJAN		FACILITY TYPE:	840
ADDRESS:	6991 BALBOA AVENUE		TELEPHONE:	(858) 221-3744
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92111
CAPACITY:	56	CENSUS: 35	DATE:	11/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:55 PM
MET WITH:	Marissa Lujan		TIME COMPLETED:	05:15 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	(3) Licensing Program Analysts (LPAs) Selina Siao and Elizabeth Rivera conducted an unannounced random inspection along with a capacity increase inspection. Facility is currently licensed to care for up to 56 children in the Multipurpose room. Facility submitted a capacity increase request for 140 children by adding rooms C7, room 50 and 52. Upon arrival, LPAs observed 13 children in the Multipurpose room with Director Marissa Lujan and teacher Cinthia Magana. There were 22 younger school age children outside lined up getting ready to go to the grass area supervised by teachers Taylor Fin and Makayla Murphy. All required notices, forms and license were posted. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation and drinking water from an operational water fountain. There are multiple laundry baskets as storage for backpacks located in the multipurpose room. Bathroom is lighted and has ventilation. Facility provide snacks for the children and monthly menu is posted. Adequate snacks are available for children. Cleaning supplies are kept inside a locked cabinet. Outdoor play area is a the black top, grass area and the swing set that is age appropriate for children ages 5-12. There are rubber cushioning under and around the swing sets. Climbing structure located at the other end of the playground will not be sure for the children in care. Area has a shade under the eating bench area next to the black top. Outdoor and indoor areas have drinking water available for children. The drinking fountains are free of debris or potential hazards. LPAs reviewed sign in sheets, first aid supplies and medication policy and storage.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2019

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 @ KAVOD	FACILITY NUMBER: 376701382
	VISIT DATE: 11/05/2019

NARRATIVE

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Personnel and children's records were reviewed. All personnel have required criminal record and child abuse index clearances. All staff members have the required immunizations and have completed the online mandated child abuse training. LPA reviewed Emergency Disaster Plan and last fire drill was conducted on 10/28/2019. An updated roster was obtained during the inspection. Reporting requirements and AB633 was also reviewed.

Three out of four of the staff members have the a current EMSA pediatric approved CPR and First Aid card. Facility has an operating carbon monoxide detector in all the rooms including the new rooms C7, 50 and 52. All three rooms were inspected and the rooms have age appropriate desk and chairs for children. No hazardous are accessible to children. Fire clearance for the requested capacity for 140 children was approved on 10/08/2019.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. Provided Director with Effects of Lead Exposure, Car Seat Poster Jan/2017, Best Practice on Supervision and Information on how to prevent Heat Related Illness.

**The facility appears to be in substantial compliance and a capacity increase to 140 children will be effective tomorrow**

A Notice of Site Visit was posted today, and Site Director was explained that it must remain posted for a period or 30 days. Failure to keep notice posted will result in a civil penalty of $100.00

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2019

LIC809 (FAS) - (06/04)

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