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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700551
Report Date: 10/07/2022
Date Signed: 10/07/2022 01:12:07 PM

Document Has Been Signed on 10/07/2022 01:12 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YOUNG CHAMPIONSFACILITY NUMBER:
015700551
ADMINISTRATOR:KAREKAR, RENUKAFACILITY TYPE:
850
ADDRESS:34183 FREMONT BOULEVARDTELEPHONE:
(510) 557-4137
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 45TOTAL ENROLLED CHILDREN: 34CENSUS: 26DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Renuka Karakar TIME COMPLETED:
01:30 PM
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On October 7, 2022 at 8:45AM Licensing Program Analyst (LPA) Kelly Phan arrived for an unannounced Required-1 Year inspection, and met with director Renuka Karakar and licensee Ratna Singhal. There were 26 children and 6 fingerprint cleared staff members present during the inspection. The facility is in ratio today. The facility was toured for a health and safety inspection. Hours of operation are Monday through Friday, 8:30am to 6:00pm.

CLASSROOMS: The facility is located in a shopping mall plaza. There are three (3) classrooms that were inspected; between the hours of 3PM to 6PM there are 2 classroom that is used for heritage, however 1 room is not being used as of right now. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. There is also a gate that separates each classroom by different age groups. Facility uses cots for sleeping and will ask parents to clean bedding and blankets every Friday. The isolation area for sick children is the common area, away from other children in care. The center has smoke detectors, working telephone, and three (3) fully charged 2A10BC fire extinguishers and carbon monoxides that is inspected every year by Fire Shield, last inspected was in April 2022. Facility also has a separate room near the office that is used for storage, which is OFF limits to children

BATHROOMS: The staff's bathroom is separate from the children's bathroom; per licensee, only heritage children will use it occasionally. All sinks and faucets are in safe and sanitary operating condition. The children can reach the sinks and toilets. Per licensee, some children are still transitioning from pull-ups to toilet as there were portable potties available. There are plenty of paper and soap supplies are available to the children. Hazardous and other potential toxins are made inaccessible to children.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YOUNG CHAMPIONS
FACILITY NUMBER: 015700551
VISIT DATE: 10/07/2022
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FOOD SERVICE AREAS: This facility provide snacks for the children; Facility is also utilizing local vegetarian catering program located on same shopping plaza. Children are given the options to bring their own lunches or participate in the catering program. All food are in original containers and properly stored. The facility also has a separate area for staff that is OFF limits to children.

OUTDOOR PLAY AREA: There is a separate play area that is only used for the center as it is gated and needs a key to enter. The facility is using ropes and buggy system to transport children to the play area. Children will also bring their own water bottles during outdoor activities. There's a play structure with a slide that has cushioning to absorb falls and a canopy that provides shade to children while at play; per licensee, the play area can only occupied about 35 children at a time.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. At 10:00AM, six (6) children's files were reviewed and founded to be complete. Five (5) staff files were also reviewed. All staff files have required health screening and Employee Rights and all children files contain Identification & Emergency, Personal Rights, and Medical Consent forms. There were 2 staff files that did not have required immunization of Measles, Mumps, and Rubella (MMR), Tdap or Pertussis, and flu vaccine or declaration of declining the flu on file; However staff members were able to prove proof of the required vaccines today. LPA also reviewed the facility roster and obtained a copy. Mandated Reporter Training was discussed, and certificates were reviewed. Center director's CPR and First Aid certificate are valid until 02/15/2022 to 02/15/2024. LPA advised licensee that all openers and closers need EMSA approved CPR and First aid trainings on file. Licensee understood. The center is using a QR code system to capture parent's signatures; LPA also suggests to have a consent form to use the electronic system in place of the written sign in/out procedure to be in compliance; per licensee she would also have blank sign in/out sheets as a back up if electronic system does not work. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 09/02/22. All required documents are posted in a public accessible area. Menu is also posted and rotated each week. SEE LIC 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YOUNG CHAMPIONS
FACILITY NUMBER: 015700551
VISIT DATE: 10/07/2022
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HEALTH RELATED SERVICES: There's IMS offered at the facility, however no medication being stored at the facility and given to any children. The center is equipped with a fully stocked first aid kit that is available in the common area.

There were no deficiencies cited for today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with licensee, Ratna Singhal

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

Facility representative 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.

Incidental Medical Services (IMS) policy was discussed. This facility is providing IMS and IMS procedures are documented in facility handbook. 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

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YOUNG CHAMPIONS
FACILITY NUMBER: 015700551
VISIT DATE: 10/07/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
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