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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004219
Report Date: 08/25/2020
Date Signed: 08/25/2020 03:02:48 PM

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 - FRANKLIN ELEMENTARYFACILITY NUMBER:
414004219
ADMINISTRATOR:TABORA, JOANNE, DIRFACILITY TYPE:
840
ADDRESS:2385 TROUSDALE DRIVETELEPHONE:
(650) 867-6046
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY:137CENSUS: 0DATE:
08/25/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Brennan BernardoTIME COMPLETED:
03:00 PM
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Due to the COVID-19 health crisis, and state, local county orders, a tele-inspection was conducted. Licensing Program Analyst (LPA) Van met with Area Manager, Brennan Bernardo, for case management via Facetime inspection in response to an application received from the facility requesting a capacity increase and room addition. The facility is operating in a functioning school site at Franklin Elementary School in Burlingame, serving school-age children, ages 4.9 - 12. The facility is currently licensed for a capacity of 137 in classrooms #10, #19, #20, portable #23, and #24. The facility is requesting an increase of capacity from 137 children to 219 children and adding classroom #17, #18, #21, #22, library, computer lab, and the multipurpose room. The facility has included a letter from the Chief Business Officer of Burlingame School District that permits the facility to use the mentioned rooms to be added to the license.

Mr. Bernardo leads LPA on a virtual inspection of the facility indoors for Health and Safety Hazards. Per the facility sketch that was submitted, Fire Inspector, Julie Parenti, noticed a few rooms that had incorrect square footage. During the fire inspection on August 17, Ms.Parenti had corrected the measurement for room #17, #18, #21, and #22.

· The multipurpose room measures 2846 sq foot, which allows a maximum of 81 children.
· The library measures 1186 sqft, which allows 33 maximum children.
· Room #21 measures 924 sqft, which allows a maximum of 26 children.
· Room #22 measures 924 sqft, which allows a maximum of 26 children.
· Room #17 measures 896 sqft, which allows a maximum of 25 children.
· Room #18 measures 896 sqft, which allows a maximum of 25 children.
· Computer lab measures 904 sqft, which allows a maximum of 25 children.
· The total number of children for the additional rooms is 241.

Continuation on the next page...
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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 - FRANKLIN ELEMENTARY
FACILITY NUMBER: 414004219
VISIT DATE: 08/25/2020
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The licensed outside play area includes the climbing structure, basketball courts, and black located near the portables. Per Mr. Brennan, the climbing structures are not being used during the COVID-19 pandemic until the facility gets approval from the Burlingame School District. Classrooms #17, #18, #21, and #22 are clean, safe, and are set up with age-appropriate furniture, equipment, and materials. Ventilation, heating, and lighting are adequate. There are Individual cubbies available for each child. A working fire extinguisher, telephone, first aid, and updated emergency disaster plan are in each classroom. The facility meets posting requirements. LPA observed that the multipurpose room, library, and computer lab had not been set up. The area manager states, the facility is working on moving tables and chairs to the rooms and will send pictures to LPA.

The facility provides snacks. The food preparation area is in portable room #23, which has adequately equipped with a refrigerator and a separate cabinet for food storage. Separate Boy's and Girl's rest-rooms are made available to allow privacy. Indoor and outdoor areas are observed to be safe and free from any Health and Safety Hazards today.

Mr. Brennan was advised that a follow-up inspection will be conducted in the future, and the measurement of indoor and outdoor space may be required.

Fire clearance was granted on 08/17/20.

Prior to Licensure:
1) Submit LIC 500, and LIC 309
2) Qualification for new Director, Megan Pallante
3) Superintendent Certification.
4) Multipurpose room, library, and computer lab need to have appropriate chairs, tables, learning materials for children.
5) Reviewed/Approved by Management, License will be updated for a capacity increase to 219 School-age children.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2020
LIC809 (FAS) - (06/04)
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