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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622564
Report Date: 06/19/2023
Date Signed: 06/19/2023 09:44:12 AM


Document Has Been Signed on 06/19/2023 09:44 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:KCE CHAMPIONS LLC @ TRACY LEARNING CENTERFACILITY NUMBER:
393622564
ADMINISTRATOR:BECK, BRITTANYFACILITY TYPE:
840
ADDRESS:51 E. BEVERLY PLACETELEPHONE:
(209) 207-4461
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:84CENSUS: 10DATE:
06/19/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Brittany BeckTIME COMPLETED:
10:15 AM
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Application Specialist (AS) Alecia Sifuentes met with Site Supervisor Brittany Beck for the purpose of a case management inspection. Licensee requests to add addition classrooms to the already existing classrooms. Licensee is not making any changes to the capacity. The program currently operates Monday through Friday from 6:00 a.m. to 7:45 a.m. and 3:30 p.m. to 6:00 p.m. The program is located at the charter school, Tracy Learning Center. The school's passing annual fire inspection report was received on 6/9/2023.

A health and safety inspection was conducted in all areas accessible to children. The school-age children currently occupy rooms P2, P6, and the school gym. Superintendent/Principal letter is on file allowing the program to utilize classrooms P2, P3, P4, P5, P6, P7, P8, D10 (upstairs), and the school gym. Per Health and Safety Code 1596.806, the facility is exempt from square footage requirement; therefore, AS did not take measurements. The children will use the school’s restrooms. There is a separate private restroom for the staff.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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.

Exit interview conducted and report was reviewed with the Site Supervisor, Brittany Beck.

Effective today, 6/19/2023, AS will approve the additional classrooms.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2023
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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