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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004697
Report Date: 12/30/2020
Date Signed: 12/30/2020 12:04:00 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KCE CHAMPIONS LLC @ MCKINLEY ELEMENTARY (SA)FACILITY NUMBER:
414004697
ADMINISTRATOR:VAZQUEZ, MELISSAFACILITY TYPE:
840
ADDRESS:701 PALOMA AVENUETELEPHONE:
(650) 906-1762
CITY:BURLINGAME,STATE: CAZIP CODE:
94010
CAPACITY:140CENSUS: 0DATE:
12/30/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brennan Bernardo and Shereen NajjarTIME COMPLETED:
12:00 PM
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Due to COVID-19 and Shelter in Place Order, an Informal Office meeting is conducted virtually, via Zoom Meeting. Present at the meeting are a Licensing Program Manager (LPM) Leung, Licensing Program Analyst (LPA) Van, Champions Area Manager, Brennan Bennardo, and Site Supervisor Shereen Najjar.

The purpose of this meeting is to discuss an unusual incident that occurred on 12/10/2020. A child left the facility and walked home without staff knowledge. According to the staff, the child left the classroom, climbed the fence, and walked home. This information was revealed when the child's guardian called the facility and notified that the child was home safely. On the same day, staff underwent more training on supervision; an additional teacher is now positioned by the door, and that the classroom's door remains closed.

Since the incident, more changes have been implemented to ensure that such incidents from reoccurrence. Area Manager Brennan Bennardo provided copies of the implementation procedure stated below.

· Each group is staffed with two permanent and fully dedicated staff members.
· One teacher will be responsible for maintaining the Sign Out/ID process.
· A name to face headcount is done both before and after each transition.
· Each door/exit/boundary will be assigned to a teacher to supervise.
· Doors to the classrooms will always be kept closed to maintain visual and physical barriers for the children.
· Two teachers will be scheduled to close the program daily, regardless of the number of children present.

This report was emailed to Area Manager Brennan Bennardo and Shereen Najjar.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2020
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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