343617498-4-8-2024-03-CC-EPGO-D45NLZ-20240408103422

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343617498
Report Date: 04/08/2024
Date Signed: 04/08/2024 10:34:27 AM

Document Has Been Signed on 04/08/2024 10:34 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	CHAMPIONS @ SUNRISE ELEMENTARY		FACILITY NUMBER:	343617498
ADMINISTRATOR/ DIRECTOR:	FULTZ, SANDY		FACILITY TYPE:	850
ADDRESS:	11821 COBBLE BROOK DRIVE		TELEPHONE:	(916) 667-2936
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95742
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 18	CENSUS: 13	DATE:	04/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:			TIME VISIT/ INSPECTION COMPLETED:	10:45 AM

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Licensing Program Analyst Erwina Pascual-Golamco and Loraine Perez (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 13 preschool children being supervised by 2 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, 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.

Classrooms observed are in good repair and free of hazards with heating and ventilation for safety and comfort. The facility has equipment and age-appropriate materials for children. 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 and minimal food preparation occurring in the classroom.

Bathrooms were sanitary, sinks and toilets were 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 required licensing documentation was posted for parental review. LPA observed that parents are signing their children in and out of the center.

continued on LIC809C...

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHAMPIONS @ SUNRISE ELEMENTARY	FACILITY NUMBER: 343617498
	VISIT DATE: 04/08/2024

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LPA reviewed with Director the LIC311A, Records to Be Maintained at The Facility, for child's records, personnel records, administrative records, and documents to be posted. Sample of children and staff files were reviewed. Children’s file had the required licensing documentation. LPA reviewed staff transcripts and observed staff were qualified. At least one staff had a current Pediatric CPR and First Aid certification. LPA observed a current children's roster and a fire drill log. There is First Aid equipment available.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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-care-centers/.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES. 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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Director was informed of the https://mychildcareplan.org/; a consumer education website that helps families obtain childcare by connecting them to childcare 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.

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: 04/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024

LIC809 (FAS) - (06/04)

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