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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210355
Report Date: 02/10/2026
Date Signed: 02/10/2026 02:03:07 PM

Document Has Been Signed on 02/10/2026 02:03 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:KCE CHAMPIONS LLC @ SANTA MARGARITA PSFACILITY NUMBER:
406210355
ADMINISTRATOR/
DIRECTOR:		D. K. VACAFACILITY TYPE:
850
ADDRESS:22070 H STREETTELEPHONE:
(805) 703-3778
CITY:SANTA MARGARITASTATE: CAZIP CODE:
93453
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 4DATE:
02/10/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Taylor BrownTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On 2/10/26, at 12:30 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an annual random inspection of the abovementioned Child Care Center (CCC). LPA met with Taylor Brown, Site Supervisor of the CCC, and explained the purpose of the inspection. LPA toured the entirety of the the CCC (interior and exterior). The CCC uses one classroom (Classroom 805), a set of bathrooms, and one playground. The CCC is on the grounds of Santa Margarita Elementary School.

The CCC operates Monday through Friday from 8:00 AM until 11:20 AM and from 11:40 AM until 6:00 PM. At the time of the inspection, LPA observed 4 children in care. Besides the Site Supervisor, LPA observed 4 additional staff members. Of those 4, three staff members are cleared and associated. LPA also observed the Area Manager, Dawn Martin.

The classroom of the CCC is clean and orderly. The classroom has age-appropriate equipment and furnishings for children in care. The classroom contains a number of closets and storage spaces all of which contain items, equipment, and other related objects for children in care. As mentioned prior, there is a set of bathrooms that are available for children to use. The bathrooms are a distance from the classroom near the outdoor playground area. Both bathrooms possess an adequate numbers of toilets and sinks for children in care. There are 3 sinks in each bathroom. In the girls bathroom, there are 3 toilets and in the boys bathroom, there are 2 urinals and 2 toilets. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care.

At the CCC, one snack is provided for children in care. Filtered water is provided by the CCC via a water dispenser. Children bring reusable water bottles from home to drink with with and disposable cups are available.

CCCs constructed before 1/1/20, are supposed to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Through interview and record review, LPA confirmed that lead testing is valid through June of 2028. (CONT. LIC 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KCE CHAMPIONS LLC @ SANTA MARGARITA PS
FACILITY NUMBER: 406210355
VISIT DATE: 02/10/2026
NARRATIVE
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LPA observed daily routine schedules, required notices, and other relevant licensing documents posted prominently in the classroom. At the CCC, children's sign in and sign out sheets can be completed on paper or digitally via the Line Leader/Discover Champions application. LPA found that the CCC completed their most recent disaster drill on 11/18/25 due to an Earthquake in the area. Site Supervisor informed LPA that the CCC conducts disaster drills every month, however, holiday scheduling recently interrupted this routine.

In the classroom, a carbon monoxide detector was tested at 12:05 PM and was found to be operational. The CCC's smoke detectors were not tested by the LPA as the detectors are integrated in the elementary school's fire detection system. LPA was informed the elementary school's fire detection system is monitored by school service personnel. Cleaning supplies are stored in an elevated cabinet in the classroom, out of reach of children in care. Sharps, like scissors, are stored in a secure drawer within the teacher's desk. Medication is kept in a secure lockbox and is stored in an elevated cabinet in the classroom. LPA viewed various First Aid Kits in the CCC. The First Aid Kits were observed to contain appropriate supplies.

As mentioned prior, the CCC has access to an outdoor play yard. The outside playground area is enclosed by chain linked fencing and gates. The fence’s entry and exit gates in the yard are secure and furnishings in the area are age appropriate. The play equipment is free of sharp, loose, or pointed objects. The play structure in the outdoor playground area has adequate cushioning to absorb falls (playground foam). The surface of the outdoor playground area is varied. The areas are made up of both concrete pavement, natural grass, black top, and playground foam. Shade is provided by neighboring trees and by classroom building overhangs. During the warm summer months, canopies are also installed if there's the need. Site Supervisor also informed LPA that children can also play on a nearby blacktop. The blacktop is sectioned off by cones to create a perimeter for children in care. Facility Representative attested to LPA that children are always supervised while outside and that the outdoor area is inspected prior to letting children outside.

A sampling of staff and children's records were reviewed. The children’s records were complete and were found to contain emergency contact information as well admission agreements, among other relevant licensing documents and forms. Staff records were reviewed and contained current Mandated Reporter Training certificates among other relevant licensing documents. LPA confirmed that there are no bodies of water, firearms, or ammunition that are on site.

LPA discussed the safe sleep regulations with Site Supervisor and discussed the Child Care Licensing Safe Sleep at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KCE CHAMPIONS LLC @ SANTA MARGARITA PS
FACILITY NUMBER: 406210355
VISIT DATE: 02/10/2026
NARRATIVE
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as an additional resource. This facility does not currently care for infants 24 months and under.

This facility does currently provide Incidental Medical Services – IMS. LPA reviewed storage of medication equipment and supplies, and also reviewed children’s, personnel, and administrative records related to such needs. 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 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/.



Facility representative was reminded that all adults 18 and over, including employees and volunteers, as specified in HSC 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.

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.

During today's inspection, one Type A citation was issued (see (LIC 809-D page).

Upon receipt, the Site Supervisor shall provide copies of this licensing report to parents and guardians of children in care and to parents and guardians of children newly enrolled at the facility during the next 12 months. The Acknowledgement of Receipt (LIC 9224) shall be completed and signed by each parent and guardian with copies maintained in each child's file. The Site Supervisor was informed that any additional Type A citations may result in further administrative action against the CCC.



During the exit interview, the Facility Representative confirmed that there are no Registered Sex Offenders present at the facility when the LPA completed an RSO profile in FAS on 2/10/26.

Facility Representative was provided with Appeal Rights (LIC 9058) and a Notice of Site Visit (LIC 9213). The Notice of Site Visit form must be posted for 30 days or a civil penalty of $100 may apply.

An exit interview was conducted, and the report was reviewed with Facility Representative, Taylor Brown.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/10/2026 02:03 PM - It Cannot Be Edited


Created By: Matthew Sapien On 02/10/2026 at 12:23 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KCE CHAMPIONS LLC @ SANTA MARGARITA PS
FACILITY NUMBER: 406210355

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/11/2026
Section Cited
HSC
1596.871(c)(1)(A)

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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...

This requirement is not met as evidenced by:
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On or before, 2/11/26, the CCC will have a background check completed for the aforementioned individual. A copy of the live scan form needs to be sent over via email and a written plan also needs to be submitted detailing how such occurences will be avoided moving forward.
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Based on interview, observation, and record review, the CCC did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Teacher's Aide, Yasmine Corona has not completed their Criminal Record Clearance (CRC).
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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.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Matthew Sapien
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/10/2026


LIC809 (FAS) - (06/04)
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