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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806377
Report Date: 02/19/2025
Date Signed: 02/19/2025 02:41:04 PM

Document Has Been Signed on 02/19/2025 02:41 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:JAMUL-DULZURA UNION SCHOOL DISTRICT PRESCHOOLFACILITY NUMBER:
370806377
ADMINISTRATOR/
DIRECTOR:		EMERICK, JENNIFERFACILITY TYPE:
850
ADDRESS:14545 LYONS VALLEY ROADTELEPHONE:
(619) 669-7771
CITY:JAMULSTATE: CAZIP CODE:
91935
CAPACITY: 44TOTAL ENROLLED CHILDREN: 21CENSUS: 10DATE:
02/19/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Jennifer EmerickTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On February 19 ,2025, at 1:30 p.m., Licensing Program Analysts (LPAs) Angela Nguyen and Gloria Gonzalez, conducted an unannounced case management visit to follow up on two self reported Unusual Incidents that occurred on or about 1/14/2025 and 1/23/2025. LPAs met with Site Supervisor, Jennifer Emerick. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a full day program and half day program which operates according to the Jamul- Dulzura Unified School District school schedule. The morning half day program operates from 8:30 a.m. to 11:30 a.m. and the full day program operates from 8:00 a.m.. to 4:30 p.m. There are two classrooms in operation (Classroom #1 and classroom #2). The following ratios were observed: Classroom #1 (serves children age 2 through 5 years). Classroom #2 is not being used due to low enrollment. There were 10 children present with 2 staff members.

An unusual incident was submitted to Licensing on 1/14/2025. At approximately 11:20 a.m., Child #1 (C1) tripped over her feet and sustained an injury to the head in the classroom. Staff immediately preformed first aide to C1 and notified parents by phone and when they arrived at pick up at 11:30 a.m. C1 returned to school on her following scheduled day.

On 1/23/2025 at approximately 2:10 p.m. Child #2 (C2) was on the playground picking a toy from a picnic table. As C2 turned away from the table, C2 tripped over a tricycle wheel and sustained a spinal fracture to his left femur. Staff and school nurse applied first aide. Site Supervisor contacted parent's of C2. Mom arrived approximately 2:40 p.m. to take C2 to the hospital for further evaluation.

LPAs conducted staff and children interviews regarding both incidents. Based on the information obtained during the incident investigation, the incidents appear to be an accident. This concludes the incident investigation. No deficiencies were cited during this inspection. A Notice of Site Visit (LIC 9213) was provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed Notice of Site Visit posted on the wall in classroom #1.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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