334807508-2-27-2025-09-CC-TDIP-DEB4UG-20250227182442

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334807508
Report Date: 02/27/2025
Date Signed: 02/27/2025 06:24:53 PM

Document Has Been Signed on 02/27/2025 06:24 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY SCHOOL		FACILITY NUMBER:	334807508
ADMINISTRATOR/ DIRECTOR:	DESIREE PADILLA		FACILITY TYPE:	840
ADDRESS:	20440 RED POPPY LANE		TELEPHONE:	(951) 653-9477
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92508
CAPACITY: 66	TOTAL ENROLLED CHILDREN: 46	CENSUS: 16	DATE:	02/27/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Tori Gayman		TIME VISIT/ INSPECTION COMPLETED:	06:30 PM

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 02/27/2025 at 1:15 PM, Licensing Program Analyst (LPA) Tiffanie Diep arrived at the facility to conduct an annual inspection. LPA toured the facility inside and out, records were reviewed, and the following was observed and/or discussed: · This is not a combination center. · Normal days and hours of operation are Monday through Friday from 6:00 AM to 8:00 AM, Monday through Tuesday and Thursday through Friday from 2:00 PM to 6:00 PM, and Wednesday from 1:15 to 6:00 PM. · A review of staff and children's records was conducted as part of this evaluation. · The facility was operating with the limits as stated on the license. · Ratios were being met during the inspection. · Classrooms were adequately equipped with age and size-appropriate furniture and equipment and free of hazards. · There are no weapons present at the facility per Director Tori Gayman. · Director confirmed there are no accessible bodies of water present at this time. All wading pools or similar products must be emptied immediately after use. LPA referred Director to the Department website for new pool safety requirements effective January 1, 2025: Child Care Provider Webinar 2024 Q4 and PIN 25-01-CCP. · Uncontaminated drinking water was readily available both indoors and outdoors and provided by filtered water in water jugs and disposable cups. · Water testing for lead contamination was completed on 12/10/2022. · Medications were stored where inaccessible to children. · All hazardous items, such as disinfectants, cleaning solutions, and other items that could pose a danger were not stored inaccessible to children. Continues on LIC 809-C

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY SCHOOL	FACILITY NUMBER: 334807508
	VISIT DATE: 02/27/2025

NARRATIVE

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Continued from LIC 809 (Page 2)

· Toxins were not locked. LPA observed multiple cleaning compounds, including bottles of disinfectant solutions and sprays and a can of insecticide, in a cabinet with a magnetic latch that was not secured. All items indicate they are poisonous if swallowed or inhaled. There were no day care children present at the beginning of the inspection. LPA discussed the requirement to ensure storage areas for poisons are locked.
· All floors were observed to be clean and safe.
· Restrooms were observed to be safe, sanitary, and in operating condition.
· Outdoor activity areas were supplied with age and size-appropriate equipment in good condition.
· Playground was enclosed by appropriate fences and were free of hazards.
· Food preparation area was clean, free of litter, rubbish, and free of rodents and other vermin.
· Food was stored appropriately and protected from contamination.
· All storage containers for solid waste, including moveable bins, had tight-fitting covers that were kept on and in good repair.
· Menus were posted at least one week in advance in a place visible by the child’s authorized representative, dated, kept on file for 30 days, and made available upon request.
· The areas around or under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs a fall, which was wood chips.
· Sign-in/out records were reviewed and met regulation requirements.
· Children’s records were complete.
· Staff records reviewed during today’s inspection indicate that all facility staff or other individuals who require caregiver background checks have received all required clearances or exemptions and meet minimum qualifications for the position for which they were hired.
· Director completed preventive health and safety training on 10/20/2024.
· A staff member was present with current pediatric CPR and first aid certification which expires on 10/19/2026.
· Director’s Mandated Reporter Training certificate expires on 10/03/2026.
· Documentation of fire and disaster drills was on file; last drill was conducted on 02/05/2025.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY SCHOOL	FACILITY NUMBER: 334807508
	VISIT DATE: 02/27/2025

NARRATIVE

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Continued from LIC 809-C (Page 3)

· Director was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting e-mail at UnusualIncidentReportsDO09@dss.ca.gov.
· Director can submit transfer forms to associate new individuals or to disassociate someone from the facility via e-mail to Associations_Disassociations862@dss.ca.gov.
· The Duty Officer is available to answer questions Monday through Friday from 8:00 AM to 5:00 PM at (951) 782-4200.

The following items were posted and updated where necessary:
· License
· Emergency Disaster Plan (LIC 610) and Earthquake Preparedness Checklist (LIC 9148)
· Notification of Parents' Rights poster (PUB 393)
· Personal Rights (LIC 613A)
· California Child Passenger Safety Law (PUB 269)
· Menu

The director is asked to update the following documents, if applicable, and submit to Licensing within 30 days:
1. Designation of Facility Responsibility (LIC 308) (only if changes have been made)
2. Administrative Organization (LIC 309) (only if changes have been made)
3. Personnel Report (LIC 500)
4. Emergency Disaster Plan (LIC 610)
5. Parent Handbook/Program Curriculum/Admission policies and procedures/Fee schedule (only if changes have been made)

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY SCHOOL	FACILITY NUMBER: 334807508
	VISIT DATE: 02/27/2025

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Continued from LIC 809-C (Page 4)

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every five years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information, see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may be sent to the e-mail address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE Tool, please send e-mail inquiries 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/inspection-process. Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on LPA’s observation, a deficiency is being cited on the attached LIC 809-D. LPA Tiffanie Diep informed the Director, Tori Gayman, that this report dated 02/27/2025 documents one Type B citation as there was a potential risk to the safety of children in care.

An exit interview was conducted and report was reviewed with the director, Tori Gayman. A notice of site visit was given to Director and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/27/2025 06:24 PM - It Cannot Be Edited

Created By: Tiffanie Diep On 02/27/2025 at 06:05 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KCE CHAMPIONS LLC @ TOMAS RIVERA ELEMENTARY SCHOOL	FACILITY NUMBER: 334807508
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)(1)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. (1) Storage areas for poisons shall be locked. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the director did not comply with the section cited above as director did not ensure poisons, including bottles of disinfectant solutions and sprays and a can of insecticide, were locked which poses a potential safety risk to children in care. The poisons were located in a cabinet with a magnetic latch that was not secured.
	POC Due Date: 03/27/2025
	Plan of Correction
1 2 3 4	There were no day care children present at the time of inspection. LPA discussed the requirement to ensure storage areas for poisons are locked. Director agreed to either dispose of the poisons or place the poisons in a locked area and provide proof to LPA by 03/27/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Ana Noble

LICENSING EVALUATOR NAME:

Tiffanie Diep

LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025

LIC809 (FAS) - (06/04)

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