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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376701350
Report Date: 04/12/2024
Date Signed: 04/12/2024 02:27:34 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/11/2024 and conducted by Evaluator Nancy Diaz
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20240411144230
FACILITY NAME:KCE CHAMPIONS LLC AT WALKER ELEMENTARYFACILITY NUMBER:
376701350
ADMINISTRATOR:VICTORIA ALBERTSONFACILITY TYPE:
840
ADDRESS:9225 HILLERY DRIVETELEPHONE:
(619) 746-9178
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:100CENSUS: 12DATE:
04/12/2024
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:KATHRYN CZERWINSKITIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff did not provide adequate supervision to day care children.
INVESTIGATION FINDINGS:
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On 4/12/2024 @ 12:50PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection in reference to the above allegation. Staff Samantha Seabrooks arrived at approximately 1:30PM. Ms. Seabrooks stated that staff were unaware that it was minimum day on 3/13/2024. Children were dismissed at 12:15pm. She was notified of the situation and immediately drove to the site and arrived at 1:05pm. There were approximately 18 children playing at the black top area, supervised by school staff and School Principal, Regina Serbin.
Based on LPA's interviews with staff, it was determined that the preponderance of evidence has been met. There is enough supporting information to prove that staff failed to provide adequate supervision to day care children. The allegation is deemed to be SUBSTANTIATED, see deficiencies cited on the attached LIC 9099D. REPEAT VIOLATION
Exit interview was conducted with Katie Czerwinski. A copy of this report, appeal rights and notice of site visit were given. Notice of Site shall be posted for 30 day.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 51-CC-20240411144230
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 WALKER ELEMENTARY
FACILITY NUMBER: 376701350
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/12/2024
Section Cited
CCR
101229(a)(1)
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RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION.
No children shall be left without the supervision of a teacher at any time...
THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY:
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REPEAT VIOLATION.
This deficiency was corrected when a staff showed up at 1:30PM.
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Based on LPA's interview with staff, it was determined that staff failed to provide adequate supervision when children were dismissed from school at 12:15PM. Staff did not arrived on site until 1:05PM.
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Ms. Czerwinski will submit a statement on Monday, April 15th regarding plan of action for incidents such as this.
Type B
04/15/2024
Section Cited
CCR
101212(d)(1)(C)
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REPORTING REQUIREMENTS.
Upon the occurrence, during the operation of the child care center of any of the events specified...Any unusual incident..
THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY:
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Ms. Czerwinski will attend Component 3 orientation immediately and submit a copy of training certificate by 4/15/2024.
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Based on staff interview, staff failed to report to the department an incident involving staff's failure to provide adequate supervision when on 3/13/24, there were no staff available to supervise 18 children when they were dismissed from the elementary school.
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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.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 51-CC-20240411144230
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 WALKER ELEMENTARY
FACILITY NUMBER: 376701350
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2024
Section Cited
CCR
101218
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ADMISSION POLICIES. Every child care center shall have all admission policies in writing and available to the public. The policies shall coincide with the limitations stated on the license, and shall include, but not be limited to, the following...
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Ms. Czerwinski, moving forward appropriate scheduling of staff, checking the calendar and continued communication with school staff.
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THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY:
Facility failed to provide adequate supervision to children who is currently participating in the program when school was dismissed at 12:15PM and there were no staff to provide supervision.
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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.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3