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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 406215479
Report Date: 09/14/2023
Date Signed: 09/14/2023 04:08:13 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/08/2023 and conducted by Evaluator Martina Jimenez
COMPLAINT CONTROL NUMBER: 17-CC-20230908152424
FACILITY NAME:KCE CHAMPIONS LLC @ SAN GABRIEL PSFACILITY NUMBER:
406215479
ADMINISTRATOR:TAMARA PAYNE-ALEXFACILITY TYPE:
850
ADDRESS:8500 SAN GABRIEL ROADTELEPHONE:
(805) 952-5083
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:23CENSUS: 11DATE:
09/14/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Deri-Kaye RipelTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Staff is interfering with the daycare children's nap schedule
INVESTIGATION FINDINGS:
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On September 14, 2023 at 1:30 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced inspection to itiniate the complaint investigaton on the above mentioned allegation. LPA met with Site Director, Deri- Kay Ripel, and discussed the purpose of the inspections. LPA observed 11 children napping at the time of the inspection, with 1 staff present.

The investigation included LPAs observation, one site inspections, document reviews and interviews with the Site Director. The Site Director denies the allgeration noted above.

Interview, document reviews as well as LPAs' observations did not corroborate the allegation noted above. Unannounced inspection revealed the CCC does not interfer with the napping schedule of the children in care.

This report continues on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 17-CC-20230908152424
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KCE CHAMPIONS LLC @ SAN GABRIEL PS
FACILITY NUMBER: 406215479
VISIT DATE: 09/14/2023
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A Notice of Site Visit (LIC 9213) and Appeal Rights (LIC 9058) were provided to the Site Director. The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may appeal..

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2