<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617498
Report Date: 04/04/2023
Date Signed: 04/04/2023 11:18:08 AM

Document Has Been Signed on 04/04/2023 11:18 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:CHAMPIONS @ SUNRISE ELEMENTARYFACILITY NUMBER:
343617498
ADMINISTRATOR:FULTZ, SANDYFACILITY TYPE:
850
ADDRESS:11821 COBBLE BROOK DRIVETELEPHONE:
(916) 667-2936
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95742
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 14DATE:
04/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Kaeleigh WiegmanTIME COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst Erwina Pascual-Golamco (LPA) met with Site Director, Kaeleigh Wiegman for an unannounced annual inspection. LPA toured the facility, including all activity and classroom spaces, restrooms, and outdoor play area. Census included 14 preschool children being supervised by two classroom staff. Director was reminded never to exceed the conditions, limitations, and capacity specified on the license. Facility hours of operation are Monday through Friday from 6:30 AM to 12:30 PM, in portable building #2.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



Classroom is free from hazards. Chemicals were kept inaccessible to children. The preschool's outdoor area is a fenced field. Children bring their own water bottles from home and uncontaminated drinking water was readily available to children both indoors and outdoors. The facility provides morning snack. LPA observed a posted menu and observed food stored at appropriate temperature.

Bathrooms were observed and all sinks and toilets were sanitary and in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. LPA observed all required licensing documentation was posted for parental review. LPA observed that parents are signing their children in and out of the center.

continued...

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CHAMPIONS @ SUNRISE ELEMENTARY
FACILITY NUMBER: 343617498
VISIT DATE: 04/04/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
continuation...

Children and staff files were reviewed. Each child's file had the required licensing documentation. LPA reviewed staff transcripts and observed all staff caring for children were qualified. At least one staff had a current Pediatric CPR and First Aid certification. Staff all have current Mandated Reporter certificates and proof of immunizations. LPA observed a fire drill log, and Director stated she will email LPA the children's roster. There is First Aid equipment available. LPA informed and provided Director information on annual fees.

Incidental Medical Services (IMS) were discussed. For additional IMS information, Director was advised to see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Director was encouraged to visit the department's website at WWW.CCLD.CA.GOV for information regarding childcare updates, PINs, forms, regulations and legislation pertaining to childcare centers.

No deficiencies were cited during today's inspection. This report was reviewed with Director, and an exit interview was conducted. A Notice of Site Visit (NOS) was provided to Director, who will post it for a period of 30 days for parental review.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2