<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819673
Report Date: 10/24/2024
Date Signed: 10/24/2024 05:14:02 PM

Document Has Been Signed on 10/24/2024 05:14 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 @ MARK TWAIN ELEMENTARY SCHOOLFACILITY NUMBER:
334819673
ADMINISTRATOR/
DIRECTOR:		DEBORAH HILLFACILITY TYPE:
840
ADDRESS:19411 KRAMERIA AVENUETELEPHONE:
(951) 640-5943
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 26DATE:
10/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Kimberly BanksTIME VISIT/
INSPECTION COMPLETED:
05:30 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 10/24/2024 at 1:00 PM, Licensing Program Analyst (LPA) Tiffanie Diep met with Director Kimberly Banks for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/17/2024. The incident was reported by the facility within the required timeframe. Upon entry into the facility, there were no day care children present. At 1:30 PM, a staff member (S2) arrived to the facility. At 2:00 PM, another staff member (S3) arrived to the facility. At 2:24 PM, LPA observed S2 leave the facility to pick up day care children at the elementary school located on the premises. At 2:34 PM, LPA observed S2 return to the facility with 26 children.

All individuals subject to a criminal record review have obtained a criminal record clearance. 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.

Continues on LIC 809-C
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KCE CHAMPIONS LLC @ MARK TWAIN ELEMENTARY SCHOOL
FACILITY NUMBER: 334819673
VISIT DATE: 10/24/2024
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
26
27
28
29
30
31
32
Continued from LIC 809 (Page 2)

LPA made observations at the facility, obtained supporting documentation pertinent to the incident, and conducted interviews with pertinent individuals involved in the incident during today's visit. Information obtained revealed a child (C1) was not picked up on time from their elementary classroom. Interviews conducted disclosed day care children are picked up from a total of five elementary classrooms. It was disclosed that C1 is enrolled in the last classroom where children are picked up from. It was also disclosed that the staff member picking up day care children was consoling a child (C2) for approximately 15 minutes in the previous classroom on the day of the incident. Information obtained revealed that C1’s classroom was locked at the time of the staff member’s arrival after consoling C2 as it was revealed C1’s elementary school teacher escorted C1 to the administration office. Records reviewed indicated staff immediately picked up C1 from the administration office and notified all relevant parties in a timely manner. Information obtained did not indicate C1 was left without supervision at any point in time. Based on observations made at the facility, information obtained during interviews, and records reviewed, it is determined there were no violations pertaining to the incident.

There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the director, Kimberly Banks. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2