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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701390
Report Date: 04/26/2024
Date Signed: 04/26/2024 04:34:58 PM

Document Has Been Signed on 04/26/2024 04:34 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 TIERRASANTAFACILITY NUMBER:
376701390
ADMINISTRATOR/
DIRECTOR:		PRISCILLA LEALFACILITY TYPE:
840
ADDRESS:5606 ANTIGUA BOULEVARDTELEPHONE:
(858) 264-7759
CITY:SAN DIEGOSTATE: CAZIP CODE:
92124
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 11DATE:
04/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Pricilla LealTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 4/26/24 at 2:40 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced annual inspection at the facility. Upon arrival, LPA met with facility representative Site Director Priscilla Leal. This school-age program is located on the school site of Vista Grande Elementary School. The KCE Champions after school program is part of Elevate Public Charter school which is also located on the campus of Vista Grande Elementary School in back bungalows. Vista Grande Elementary has its own after school program “Primetime” that is kept separate from the KCE Champions. LPA observed 11 school-age children present with 2 staff members in classroom B-11 (bungalow). The program also has classrooms B9, B10 and B12 licensed, but is not currently using those classrooms at this time.

During this visit, LPA inspected classroom B-11, reviewed children’s records and staff records. Fire clearance was granted on 7/12/18. First Aid Kit is located in a backpack that travels with the children (classroom/playground). Medication is located in a lock box inside a locked cabinet in B-11. Both are kept inaccessible from children. Facility sign-in and outs will be located in a binder in room B-11. Last emergency drill was conducted on 1/17/2024.

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 currently utilized for the school age children were inspected. Room B-11 was observed to have age-appropriate furniture and equipment, including tables, chairs, bookshelves and other activity supplies for the children. LPA observed separate bathrooms with privacy.

There is a separate bathroom utilized for ill children separate restroom opposite children's bathrooms. There is an operational smoke/carbon monoxide combo detector located on top of medication cabinet in Room B-11. 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 a locked cabinet and refrigerator location is located near the snack cabinet. 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: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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 TIERRASANTA
FACILITY NUMBER: 376701390
VISIT DATE: 04/26/2024
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The outdoor playground area was inspected. Area has trees for shade. Play structure and equipment are age appropriate (ages 5-12 years). Drinking water is readily accessible inside and outside the classroom via water bottles which can be refilled in the classroom via extra water bottles. 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.

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: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
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 TIERRASANTA
FACILITY NUMBER: 376701390
VISIT DATE: 04/26/2024
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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 site director Priscilla Leal. 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: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
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