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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334841006
Report Date: 08/13/2024
Date Signed: 08/13/2024 02:46:53 PM

Document Has Been Signed on 08/13/2024 02:46 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHAMPIONS AT MILLER MIDDLE SCHOOLFACILITY NUMBER:
334841006
ADMINISTRATOR/
DIRECTOR:		DIANA NAVARRETEFACILITY TYPE:
840
ADDRESS:17925 KRAMERIA AVENUETELEPHONE:
(951) 789-8181
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY: 112TOTAL ENROLLED CHILDREN: 112CENSUS: 0DATE:
08/13/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Marie Milner- Interim Area Manager (present); and Jill Brown/Anastasia Rivas virtual attendanceTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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An Informal Conference was held at the Riverside Child Care Regional Office on August 13, 2024, at 1pm. Present during the informal conference were KCE Champions Representatives: Senior Licensing and Compliance Advisor, Jill Brown and Regional Manager, Anastasia Rivas virtual attendance; Interim Area Manager, Marie Milner and CDSS Licensing Program Managers (LPMs) Ana Noble and Gilbert Sena; and Licensing Program Analysts (LPAs), Susan Brewer and Giselle Carbullido.
The meeting was held to discuss the importance of communication between KCE Champions representatives and the department. Facility's compliance history was reviewed including review of repeated non-compliance concerns throughout KCE’s licensed facilities pertaining to the following Title 22 Division 12 regulations:
1) Personnel Requirements: (Staff Qualifications)
2) Staff and Children Records
3) Criminal Record Clearance
4) Physical Plant
During this meeting, it was disclosed that the following measures have been taken by KCE Champions Management:
1. In progress staff and children record audits including weekly site director meetings. 2. New hire: Review procedures; recruiting qualified staff and area manager completing record records orientation.
3. KCE company curriculum for school age program.
4. Physical Plant: Working to ensure carbon and smoke detectors at all sites; purchase of cabinets for hazards and records.
5. In-service conducted on 08/09/24 including Title 22 regulations and videos
6. Inclusion services for children with difficult behaviors
KCE management was reminded of the following:
All sites shall have a qualified director per Title 22 regulations.
All staff must be fingerprint cleared and associated to the facility prior to working at a facility.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2024
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHAMPIONS AT MILLER MIDDLE SCHOOL
FACILITY NUMBER: 334841006
VISIT DATE: 08/13/2024
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During the conference, LPMs Noble and Sena reminded KCE Champions Management of the importance for regulatory compliance in licensed facilities to protect the Health and Safety of children in care. KCE Champions was informed the Community Care Licensing Agency takes these violations seriously, and how continued repeat violations can lead to further administrative actions by the Department including Non-compliance conference and/or up to revocation of licensure.

Additionally, KCE Champions representatives were reminded to provide a copy of this licensing report dated 08/13/24 to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit Interview was conducted, and LPAs Brewer and Carbullido provided KCE Champions’ representatives with a copy of this report and appeal rights during this office visit on August 13, 2024.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHAMPIONS AT MILLER MIDDLE SCHOOL
FACILITY NUMBER: 334841006
VISIT DATE: 08/13/2024
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Staff and children records shall be complete and available for review – irrespective of staff or children’s rotations to other sites and/or for staff coverage.

The name of the childcare center director, and any fully qualified teacher(s) designated to act in the childcare center director's absence, shall be reported to the Department within 10 days of a change of childcare center director or designee(s). * Director packets to accompany notification of changes.
Submit Personnel Reports (LIC 500) to CCL as needed with staffing changes.
For additional support or inquiries, contact the assigned analyst or CCL’s duty officer. The duty officer is available for assistance, Monday through Friday, 8:00 am to 5:00 pm

KCE Champions Representatives were informed of and/or provided with the following CDSS resources:
1. Information for ongoing training and regulations: https://www.cdss.ca.gov
2. CDSS Videos- https://ccld.childcarevideos.org/
3. PINS at: https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care
4. Director Checklist and Evaluation of Director Qualifications (LIC 9096)
5. Child Care Advocates - childcareadvocatesprogram@dss.ca.gov for training.
6. Access forms & Title 22 Regulations for Child Care Center at: https://cdss.ca.gov/inforesources/community-care/policy/laws-and-regulations
7. Sign up for department and quarterly updates at: https://cdss.ca.gov/inforesources/community-care-licensing/subscribe.
8. LIC9224 Receipt of Licensing Report

During this conference, LPMs introduced the Child Care Technical Support Program (TSP) and informed KCE Champions Management that TSP is a voluntarily program to assist facilities with meeting and maintaining the requirements of operating a licensed childcare facility. Hardcopy's of documents were discussed and provided to KCE Champions Representatives related to TSP; Title 22 Regulations and Health & Safety Code sections identified above.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC809 (FAS) - (06/04)
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