414000082-6-8-2022-05-CC-BVAN-CF7NFD-20220608102521

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000082
Report Date: 06/08/2022
Date Signed: 06/08/2022 10:26:17 AM

Document Has Been Signed on 06/08/2022 10:26 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CHAMPIONS-LAS LOMITAS ELEMENTARY (SA)		FACILITY NUMBER:	414000082
ADMINISTRATOR:	PFEIFFER, SHARON		FACILITY TYPE:	840
ADDRESS:	299 ALAMEDA DE LAS PULGAS		TELEPHONE:	(650) 250-3658
CITY:	ATHERTON	STATE: CA	ZIP CODE:	94027
CAPACITY:	176	CENSUS: 0	DATE:	06/08/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Sharon Pfeiffer		TIME COMPLETED:	10:30 AM

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	On June 8, 2022, Licensing Program Analysts (LPA) Van made an unannounced Case Management inspection to increase the current License's capacity, discussed the outstanding annual fee, and COVID positive cases reported to Licensing on May 31. LPA met with Site Director Sharon Pfeiffer. The Department received an application from the Facility requesting a capacity increase on May 5, 2022. The Facility is currently licensed for 176 school-age children and requesting an increase to the capacity of 276 school-age children. Currently, there are no children present in the program. During the school year, the days and hours of operation are Monday-Friday, 7:00 – 8:00 in the morning program, and 1:30 PM – 6:00 PM in the afternoon program. The Summer hours are Monday – Friday, 7:00 AM – 6 PM. The Department received an approved fire clearance from Burlingame's Central County Fire Department on June 1, 2022. The Department has also received a letter from the Las Lomitas School principal and a certification from the Superintendent's Office approval for additional 49 classrooms to accommodate a total of 276 school-age children. The Center operates on a functioning school site at Las Lomitas Elementary school. Therefore it is exempt from indoor square footage, the number of toilets and sinks, fencing, playground space and exclusive use of this space, and isolation space. The Center has adequate equipment to support a capacity increase. continued on page 2...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHAMPIONS-LAS LOMITAS ELEMENTARY (SA)	FACILITY NUMBER: 414000082
	VISIT DATE: 06/08/2022

NARRATIVE

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LPA informed the Director of the annual fee that was past due. Director stated she would notify the Area Manager and has it taken care of. In addition, LPA also discussed the three COVID positive cases that were reported to Licensing on May 31. Per Director, all children had since returned to the program, and the Center resumed regular operation.

The capacity increase is granted effective June 8, 2022. An updated license will be mailed from the regional office.

The report was reviewed and signed by the Director, Sharon Pfeiffer. Today's report, June 8, 2022, and site visit notice will be sent to the Director email by the close of business on June 8, 2022. Confirmation of receipt is required. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022

LIC809 (FAS) - (06/04)

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