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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444417045
Report Date: 08/26/2024
Date Signed: 08/26/2024 11:58:14 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/30/2024 and conducted by Evaluator Melvin S Matos
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240530112947
FACILITY NAME:KCE CHAMPIONS LLC @ BROOK KNOLL ELEMENTARYFACILITY NUMBER:
444417045
ADMINISTRATOR:SARAH HINKLEFACILITY TYPE:
840
ADDRESS:151 BROOK KNOLL DRIVETELEPHONE:
(408) 624-0534
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:121CENSUS: DATE:
08/26/2024
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Jordan ArmstrongTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is operating out of ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Mel Matos met with Jordan Armstrong, Director, for an unannounced follow up complaint investigation. Purpose of today's investigation: Deliver investigation findings. Today's investigation was conducted in the Rec Portable Unit of the Facility. LPA toured the room, reviewed staff files, and interviewed Jordan Armstrong, Director, and one staff during today's investigation.

Based on interviews, record reviews, observations, and evidence gathered during the investigation process, the Department concludes the Facility was operating out of ratio when one partially qualified teacher opened the Facility on the following dates: 05/14/24, 05/16/24, 05/21/24, 05/23/24 and was the only staff present with anywhere from one to six children present during the dates listed above. The allegation noted above is thus found to be SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met. No deficiency issued since Facility was previously cited a Type B deficiency for the same allegation on August 26, 2024 (reference: complaint control number 07-CC-20240528132906). Exit interview conducted and report was reviewed with the Director, Jordan Armstrong. Appeal rights was also provided to Jordan prior to conclusion of today's inspection.
Notice of site visit was issued and must remain posted for 30 days
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/30/2024 and conducted by Evaluator Melvin S Matos
COMPLAINT CONTROL NUMBER: 07-CC-20240530112947

FACILITY NAME:KCE CHAMPIONS LLC @ BROOK KNOLL ELEMENTARYFACILITY NUMBER:
444417045
ADMINISTRATOR:SARAH HINKLEFACILITY TYPE:
840
ADDRESS:151 BROOK KNOLL DRIVETELEPHONE:
(408) 624-0534
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:120CENSUS: DATE:
08/26/2024
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Jordan ArmstrongTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure facility is clean and sanitized
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Mel Matos met with Jordan Armstrong, Director, for an unannounced follow up complaint investigation. Purpose of today's investigation: Deliver investigation findings. Today's investigation was conducted in the Rec Portable Unit of the Facility. LPA toured the room, reviewed staff files, and interviewed Jordan Armstrong, Director, and one staff during today's investigation.

Based on interviews, observations, record reviews, and evidence gathered during the investigation process, it is concluded that although the allegation noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Director, Jordan Armstrong. No deficiencies issued. A notice of site visit was given and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2