376105090-3-27-2024-51-CC-KLAE-D3S2G5-20240327172235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376105090
Report Date: 03/27/2024
Date Signed: 03/27/2024 05:22:43 PM

Document Has Been Signed on 03/27/2024 05:22 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	KCE CHAMPIONS LLC AT INNOVATIONS ACADEMY		FACILITY NUMBER:	376105090
ADMINISTRATOR:	MADISON WALLER		FACILITY TYPE:	840
ADDRESS:	5454 RUFFIN ROAD		TELEPHONE:	(971) 378-2516
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92123
CAPACITY: 160	TOTAL ENROLLED CHILDREN: 160	CENSUS: 36	DATE:	03/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Sara DeVito		TIME COMPLETED:	04:15 PM

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On 3/27/14 at 1:45 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced annual inspection at the facility. Upon arrival, LPA met with facility representative site director Sara DeVito. This school-age program is located on the campus of Innovations Academy. LPA observed 36 daycare children present with 5 staff members at time of inspection. Children were observed to be outside on the playground and came inside to room 106 at approximately 4:15 PM.

During this visit, LPA inspected the classrooms: 106 and Fitness Lab. Gymnasium was not in use at time of inspection. First Aid Kit/Medication is located in locked cabinet in room 106. Both are kept inaccessible from children. Facility sign-in and outs will be located via three clipboards that stay with staff members.

Per H&S Code 1596.806, facility is exempt from square footage, toilet, isolation space, outdoor activity space and fencing requirements. All indoor and outdoor activity spaces utilized for the school age children were inspected. Rooms were observed to have age-appropriate furniture and equipment, including tables, chairs, bookshelves and other activity supplies for the children. Rooms have cubbies and shelves for children’s belongings. LPA observed separate bathrooms with privacy.

There is a separate bathroom utilized for ill children in nurses office. There is an operational carbon monoxide detector located in each classroom. Snack menu is posted, as well as all other required documents. LPA observed snacks/food preparation area and observed to be free of rodents and/or vermin. Snacks are located in locked cabinets and refrigerators are in both fitness lab and room 106. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KCE CHAMPIONS LLC AT INNOVATIONS ACADEMY	FACILITY NUMBER: 376105090
	VISIT DATE: 03/27/2024

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The outdoor playground area was inspected. Area has trees & canopies for shade. LPA observed play structure to be age-appropriate and no sharp edges or hazards were visible. Drinking water is readily accessible inside and outside the classroom via bottles the children bring and can be refilled by the water fountain that has a refill station. Facility representative is reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

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. Staff records and children’s records were reviewed and found to be complete.

Facility representative 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.

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. 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-carecenters/. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KCE CHAMPIONS LLC AT INNOVATIONS ACADEMY	FACILITY NUMBER: 376105090
	VISIT DATE: 03/27/2024

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No deficiencies were cited at this inspection.

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. Exit interview conducted and report was reviewed with the facility representative Sara DeVito. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

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