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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701382
Report Date: 11/17/2023
Date Signed: 11/17/2023 04:03:30 PM

Document Has Been Signed on 11/17/2023 04:03 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KCE CHAMPIONS LLC AT KAVODFACILITY NUMBER:
376701382
ADMINISTRATOR:ALEXIA MORALESFACILITY TYPE:
840
ADDRESS:6991 BALBOA AVENUETELEPHONE:
(858) 221-3744
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY: 140TOTAL ENROLLED CHILDREN: 110CENSUS: 75DATE:
11/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Alexia Morales TIME COMPLETED:
04:15 PM
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On 11/17/23 at 1:35 PM Licensing Program Analysts (LPA’), Gerald Poindexter conducted an unannounced case management visit to follow-up on an incident involving a teacher grabbing a student’s arm. LPA met with Director Alexia Morales.

LPA conducted a brief tour of the facility. There were 58 children in three groups with 3 teachers and 3 aides present. Appropriate ratios were observed.

During the visit LPA conducted staff and child file review.

During the visit, LPA conducted staff and child interviews.

No deficiencies cited nor civil penalties given.

Exit interview conducted with the director Alexia Morales. LPA will continue incident follow up, as needed.

Notice of site visit was given, and it must remain posted for 30 days.

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2023
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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