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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750004
Report Date: 08/15/2024
Date Signed: 08/15/2024 04:46:48 PM

Document Has Been Signed on 08/15/2024 04:46 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KCE CHAMPIONS LLC @ DISCOVER OF THE ARTSFACILITY NUMBER:
367750004
ADMINISTRATOR/
DIRECTOR:		MURRAY, KEITHFACILITY TYPE:
840
ADDRESS:13247 AMETHYST RDTELEPHONE:
(760) 694-5036
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 53DATE:
08/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:04 PM
MET WITH:Cristin NilaTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On August 15, 2024, Licensing Program Analyst (LPA) Calloway made an unannounced inspection to the above facility for the purpose of conducting a Required Annual Random inspection. LPA met with facility representative who granted access. LPA and representative toured the facility inside and outside. LPA observed four children in active play with two representatives. The facility operates from 12:35 pm - 6:00 pm, Mon-Thurs. This is half day classroom and Fridays 1:00- 6:00 PM. Other children arrived later for a total of fifty-three (53) children.
Physical Plant: LPA observed one clean and safe classroom, telephone service, heating, lighting, and ventilation are adequate. There are baskets for children's belongings that were labeled in the classroom. Furniture, books, equipment, toys, and materials were age appropriate. Drinking water is available inside the classroom in the form of water dispenser and disposable cups. There is no napping equipment. Childcare is also provided in the multipurpose room. The storage of medications is locked in a cabinet inside the classroom. First Aid Kits were observed in each classroom. The Emergency Survival Kit Bin is kept sealed in several bins inside the class and one emergency backpack. Fire extinguisher, smoke detector and carbon monoxide detector are operable. There is a sprinkler system inside the ceiling. Trash cans did not have secure lids. Communication is provided via two-way radios. There were three staff that were not associated to the facility during the inspection.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004
VISIT DATE: 08/15/2024
NARRATIVE
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Bathrooms: LPA inspected the children's bathroom. The Staff use the two bathrooms near the front of the school and per the representative, the children will use those bathrooms only for emergencies. There were separate bathrooms, Men’s bathroom: had three sinks and 3 toilets and the Woman’s: had three sinks and four toilets all were functioning properly there were soap, paper towels, and toilet paper. Children primarily use the outside restrooms which Boys: had four sinks, four urinal’s, and three toilets and the Girls: had five sinks and six toilets. Both were functioning properly and age appropriate there were no hazards. LPA observed soap, toilet paper, and paper towels readily available.
Kitchen: There is a clean, fully equipped kitchen that is not used by the center. Snacks are provided inside the classroom. There were two refrigerators, one was inside a cabinet with a microwave and locked. The other was free standing. LPA observed an appropriate amount of food and snacks. The chemicals are kept separate from the food. Cleaning supplies are kept in the sink with a pad lock. There were five storage cabinets that were locked.
Outside: There is no play structure. The playground was observed to be free of debris. There is grass and concrete. There were tether ball courts, basketball courts for active play. Drinking water is available in the form of water fountains. There are no bodies of water on the premises.
Other: Children and staff files were reviewed. Current Pediatric CPR and First Aid (expires: 10/25). Transportation is not provided, and medical policy reviewed. Disaster Drills: Fire/Earthquake drills were last completed June 11, 2024, during summer program. Children are inspected for illnesses as they arrive. There is a separate room for isolation and care of ill children in a room adjacent to the classroom in the multipurpose room on a mat until the parent can pick up the child.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004
VISIT DATE: 08/15/2024
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Staff/child ratios were observed- compliant, sign in/out sheets are on paper and legible. Facility representative was reminded to access the Licensing website at www.ccld.ca.gov. to obtain information about the most recent regulatory changes and the Quarterly Updates. Medications are stored in locked cabinet. A review of medication policy indicated that prescription medication is administered only with parent's written permission. The management staff administers medication and documents the dosage, date, and time onto a log. Medication is brought and taken home by the parents daily or stored in locked cabinet. Medication is properly labeled and stored in its original container.
Facility representative 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 5 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. State law prohibits baby walkers, bouncy seats, exersaucers, or any other items that fall into that category.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) 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/.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004
VISIT DATE: 08/15/2024
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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 5 years after the date of the first test. For childcare 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). Or LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe sleep; as an additional resource. LPA also informed facility representative 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.

Facility representative was informed of the MyChildCarePlan.org website, a
consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004
VISIT DATE: 08/15/2024
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

The On Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM for questions, information, and Unusual Incident Reporting.

Per Title 22 Regulations, Division 12, Chapter 1, there are deficiencies cited during this inspection and there are Technical Violations assessed. See 809D and TV pages attached to this report.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, and Appeal Rights, and a copy of this report, were provided to Cristin Nila, Facility Representative. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/15/2024 04:46 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 08/15/2024 at 04:35 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700(b)
Written Directives for Lead Testing
(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and, record review, the licensee did not comply with the section cited above in completing a water lead test by required date and submitting proof to Licensing which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/15/2024
Plan of Correction
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Representative will provide proof of water, lead testing by POC date.
Type B
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in three staff were not associated or fingerprint cleared which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/29/2024
Plan of Correction
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Representative wil provide an update to LIcensing by POC date.
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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2024


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Document Has Been Signed on 08/15/2024 04:46 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 08/15/2024 at 04:35 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KCE CHAMPIONS LLC @ DISCOVER OF THE ARTS
FACILITY NUMBER: 367750004

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101515(b)
School-Age Child Care Center Director Qualifications and Duties
(b) All school-age child care centers shall have a director.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in the Site Director was not designated as supervisor and Licensing does not have record which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/05/2024
Plan of Correction
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Representative will provide proof of Director qualifications to Licensing by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2024


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