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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701101
Report Date: 03/07/2023
Date Signed: 03/07/2023 03:53:19 PM

Document Has Been Signed on 03/07/2023 03:53 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KCE CHAMPIONS LLC AT HEARST ELEMENTARYFACILITY NUMBER:
376701101
ADMINISTRATOR:SARAH REHARTFACILITY TYPE:
840
ADDRESS:6230 DEL CERRO BOULEVARDTELEPHONE:
(916) 387-5761
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 224TOTAL ENROLLED CHILDREN: 224CENSUS: 83DATE:
03/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Danielle CavanaughTIME COMPLETED:
04:20 PM
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On 3/7/23 at 3:05 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management visit for the purpose of delivering an amended report. Upon arrival, LPA met with area manager Danielle Cavanaugh and toured the facility. Census was 83 children in 5 groups (mostly outside) with 10 staff members present. LPA observed appropriate capacity/ratio and supervision while children were playing outside in groups. Another group of children were in the cafeteria participating in activities.

No deficiencies were cited at this visit.

Exit interview conducted and report was reviewed with facility representative area manager Danielle Cavanaugh. A notice of site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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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