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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701388
Report Date: 02/13/2020
Date Signed: 02/13/2020 10:18:06 AM

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 @ MASON - PSFACILITY NUMBER:
376701388
ADMINISTRATOR:KENDRA HEATHMANFACILITY TYPE:
850
ADDRESS:10340 SAN RAMON DRIVETELEPHONE:
(951) 640-4184
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:24CENSUS: 15DATE:
02/13/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Director Kendra HeathmanTIME COMPLETED:
10:25 AM
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Licensing Program Analysts, Joelle Redding and Tresha Souza, made an unannounced visit to evaluate the kindergarten playground for use by the preschool on a staggered schedule. A waiver request has been submitted.

The playground is equipped with swings and a play structure, for children ages 2 to 5 years, both in good repair. There is sufficient cushioning around the play structure. Two tables are present with umbrellas which would not be sufficient in the afternoon when the sun is directly on the playground. Additional shade needs to be provided. While the entire area is fenced, there is large grassy area in front of outside bathrooms that will not be used. The preschool will limit the areas of use to the blacktop and the swing and will ensure there is adequate supervision to ensure children remain within this boundary. Water bottles will be used outdoors. Space is large and adequate for 24 children.

The facility will provide an additional awning for shade and submit an updated sketch of the areas of the playground that will be in use. Upon verification of this information and approval of the Waiver, the request to use the kindergarten playground for the preschool will be granted.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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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