KCE CHAMPIONS LLC @ SANTA MARGARITA PS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 2/10/26, at 12:30 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an annual random inspection of the abovementioned Child Care Center (CCC). LPA met with Taylor Brown, Site Supervisor of the CCC, and explained the purpose of the inspection. LPA toured the entirety of the the CCC (interior and exterior). The CCC uses one classroom (Classroom 805), a set of bathrooms, and one playground. The CCC is on the grounds of Santa Margarita Elementary School. The CCC operates Monday through Friday from 8:00 AM until 11:20 AM and from 11:40 AM until 6:00 PM. At the time of the inspection, LPA observed 4 children in care. Besides the Site Supervisor, LPA observed 4 additional staff members. Of those 4, three staff members are cleared and associated. LPA also observed the Area Manager, Dawn Martin. The classroom of the CCC is clean and orderly. The classroom has age-appropriate equipment and furnishings for children in care. The classroom contains a number of closets and storage spaces all of which contain items, equipment, and other related objects for children in care. As mentioned prior, there is a set of bathrooms that are available for children to use. The bathrooms are a distance from the classroom near the outdoor playground area. Both bathrooms possess an adequate numbers of toilets and sinks for children in care. There are 3 sinks in each bathroom. In the girls bathroom, there are 3 toilets and in the boys bathroom, there are 2 urinals and 2 toilets. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care. At the CCC, one snack is provided for children in care. Filtered water is provided by the CCC via a water dispenser. Children bring reusable water bottles from home to drink with with and disposable cups are available. CCCs constructed before 1/1/20, are supposed to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Through interview and record review, LPA confirmed that lead testing is valid through June of 2028. (CONT. LIC 809-C, Page 2) NAME OF LICENSING PROGRAM MANAGER: Maria Mueller NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/10/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2026 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 5 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in set

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 2/10/26, at 12:30 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an annual random inspection of the abovementioned Child Care Center (CCC). LPA met with Taylor Brown, Site Supervisor of the CCC, and explained the purpose of the inspection. LPA toured the entirety of the the CCC (interior and exterior). The CCC uses one classroom (Classroom 805), a set of bathrooms, and one playground. The CCC is on the grounds of Santa Margarita Elementary School. The CCC operates Monday through Friday from 8:00 AM until 11:20 AM and from 11:40 AM until 6:00 PM. At the time of the inspection, LPA observed 4 children in care. Besides the Site Supervisor, LPA observed 4 additional staff members. Of those 4, three staff members are cleared and associated. LPA also observed the Area Manager, Dawn Martin. The classroom of the CCC is clean and orderly. The classroom has age-appropriate equipment and furnishings for children in care. The classroom contains a number of closets and storage spaces all of which contain items, equipment, and other related objects for children in care. As mentioned prior, there is a set of bathrooms that are available for children to use. The bathrooms are a distance from the classroom near the outdoor playground area. Both bathrooms possess an adequate numbers of toilets and sinks for children in care. There are 3 sinks in each bathroom. In the girls bathroom, there are 3 toilets and in the boys bathroom, there are 2 urinals and 2 toilets. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care. At the CCC, one snack is provided for children in care. Filtered water is provided by the CCC via a water dispenser. Children bring reusable water bottles from home to drink with with and disposable cups are available. CCCs constructed before 1/1/20, are supposed to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Through interview and record review, LPA confirmed that lead testing is valid through June of 2028. (CONT. LIC 809-C, Page 2) NAME OF LICENSING PROGRAM MANAGER: Maria Mueller NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/10/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2026 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 5 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in set

Type A citation - immediate risk to health, safety, or personal rights