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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004697
Report Date: 10/12/2022
Date Signed: 10/12/2022 05:15:53 PM

Document Has Been Signed on 10/12/2022 05:15 PM - 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:KCE CHAMPIONS LLC @ MCKINLEY ELEMENTARY (SA)FACILITY NUMBER:
414004697
ADMINISTRATOR:NAJJAR, SHEREENFACILITY TYPE:
840
ADDRESS:701 PALOMA AVENUETELEPHONE:
(650) 906-1762
CITY:BURLINGAME,STATE: CAZIP CODE:
94010
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 83DATE:
10/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Shereen NajjarTIME COMPLETED:
05:30 PM
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Program Analyst (LPA) Van performed an unannounced required annual inspection and met with the Director, Shereen Najjar. The purpose of the inspection was explained to the Director, and entry to the facility was granted. This facility is a school-aged morning, and the after-school program operates in the Mckinley Elementary School in Burlingame. The school approved the Center to use portable #27 and #28; rooms #1-12 in building 1; rooms #13- #24 in building 2; the library, the multipurpose room, and the music room. Classrooms #1-12, #13-24, the music room, and the multipurpose room were not used today. The days and hours of operations are Monday- Friday, the morning program is from 7:00 am – 9:00 am, and the afternoon program is from 3:00 pm - 6:30 pm. Today, there are 83 children supervised by eight staff members.

The Director and LPA inspected the facility for potential health and safety hazards. Per Director, in the morning, parents will sign their child in. In the afternoon, the teacher assigned to the Kindergarten and first-grader will come to the children's classroom and pick them up. Older children either come to the program directly or can gather at a designated area for the teacher to come and get them. The teacher will sign in all children, and a head count will be conducted before entering the classroom. All classrooms have age-appropriate games, books, and equipment in good repair. Classrooms have acceptable ventilation and ample lighting. LPA observed each child has cubbies with their name labeled. The facility has a centralized smoke detector, a fully charged fire extinguisher, and carbon monoxide. There are no pools, spas, or other bodies of water at the facility.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2022
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: KCE CHAMPIONS LLC @ MCKINLEY ELEMENTARY (SA)
FACILITY NUMBER: 414004697
VISIT DATE: 10/12/2022
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All cleaning solutions, poisons, and other dangerous chemicals are stored in the high cabinets with a child-proof lock in each classroom. LPA observed the unused electrical outlets have covers and installed. All the bathrooms, toilets, and sinks are clean and well-sanitized. All solid waste bins have a suitable tight-fitted lid on top. The children bring their water bottles, and the facility also has water dispensaries and water fountains by the sinks that are readily available for children. The outdoor playground area is in good repair and completely fenced for supervision.

In today's inspection, LPA reviewed random samples of children's and staff records. All children had a medical assessment, and the required licensing forms were completed. All staff has criminal record clearance. Director has a record of valid Pediatric FirstAid/CPR cards in the file and the required immunization. LPA also observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, and Notification of Personal Rights). The Director stated that Fire and Earthquake drills are conducted quarterly; the last drills were conducted on 9/30/2022.

The Director 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.

The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
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: KCE CHAMPIONS LLC @ MCKINLEY ELEMENTARY (SA)
FACILITY NUMBER: 414004697
VISIT DATE: 10/12/2022
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The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reminded the Director that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles. LPA observed that the facility has a record of required immunization of all staff.

LPA encouraged the Director to visit the CCLD website at www.ccld.ca.gov for licensing regulations and new updates. The Director can also email at childcareadvocatesprogram@dss.ca.gov and ask for the updates to be added to the email list.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
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: KCE CHAMPIONS LLC @ MCKINLEY ELEMENTARY (SA)
FACILITY NUMBER: 414004697
VISIT DATE: 10/12/2022
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During the inspection, LPA requested the following document to be sent to the Licensing office by June 30:
1. Designation of Responsibility (LIC 308)
2. Personnel Report (LIC 500)

No deficiencies were cited today. An exit interview was conducted, and the report was reviewed with the Director, Shereen Najjar. Today's report and notice of the site visit were provided to the Director. 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.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC809 (FAS) - (06/04)
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