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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701504
Report Date: 07/28/2023
Date Signed: 07/28/2023 02:29:27 PM

Document Has Been Signed on 07/28/2023 02:29 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LEARNING JUNGLE RANCHO SAN DIEGO - INFANTFACILITY NUMBER:
376701504
ADMINISTRATOR:TINA PROWANTFACILITY TYPE:
830
ADDRESS:3605 AVOCADO BOULEVARDTELEPHONE:
(619) 569-7607
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY: 48TOTAL ENROLLED CHILDREN: 39CENSUS: 28DATE:
07/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Krizia BeltranTIME COMPLETED:
02:45 PM
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On 7/28/2023, at 1:05pm., Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection to review additional information regarding a self - reported incident. Upon arrival, LPA Williamson met with Assistant Director, Krizia Beltran. LPA discussed the purpose of the inspection and proceeded to tour the facility. There were 22 napping children present with three (3) staff and six (6) additional children who were not napping and were being supervised by two (2) staff.

On 7/20/2023, the director self- reported an incident involving Child 1 (C1) [See Confidential Names]. Per Director, the alleged incident occurred on 7/20/2023 at around 11:33am. Director stated that C1 sustained an injury that required medical attention.

No deficiencies cited during today's inspection. An exit interview was conducted with Assistant Director, Krizia Beltran and a copy of this report, Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2023
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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