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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701504
Report Date: 06/28/2024
Date Signed: 06/28/2024 04:15:33 PM

Document Has Been Signed on 06/28/2024 04:15 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/
DIRECTOR:		JENNIFER RUIZ QUINTEROFACILITY TYPE:
830
ADDRESS:3605 AVOCADO BOULEVARDTELEPHONE:
(619) 569-7607
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY: 48TOTAL ENROLLED CHILDREN: 37CENSUS: 29DATE:
06/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Jaynalyn Hall and Jennifer QuinteroTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 6/28/2024, at 2:30pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection regarding a self - reported incident. LPA met with Assistant Director, Jaynalyn Hall and discussed the purpose of the inspection, and proceeded to tour the facility. There were 29 children present, 14 of whom are ages 18 to 36 months present with eight staff. At 2:40pm, Director, Jennifer Quintero arrived to the facility.

On 6/20/2024, the director self- reported an incident regarding a personal rights violation involving Child #1 (C1). Per Director, the incident occurred on 6/17/2024 at about 2:53pm.

Interviews were conducted with the director, staff and authorized representative for C1. LPA review staff and children files and obtained copies of related documentation.

Per Director, Staff #1(S1) took a bottle from the bottle warmer and placed the bottle on the table for Staff #2 2 (S2) to feed Child #2 (C2). Director stated that S2 picked up the bottle and fed C1 approximately two sips of a bottle containing breastmilk which belonged to C2. Per Director and staff both bottles were labeled with the name and date of each child. Director and staff stated there were seven (7) children present with three (3) teachers during the time of the incident.


Staff #3 (S3) immediately reported the incident to the director. Per director and C1's authorized representative, she was immediately notified of the incident. Per C1's authorized representative there was no medical attention was not required for C1.

Interviews were conducted with the director and staff. Based on interviews and documentation, it was determined that the facility staff violated the personal rights of C1.

See LIC 809C Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 - INFANT
FACILITY NUMBER: 376701504
VISIT DATE: 06/28/2024
NARRATIVE
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This is a repeat violation due to facility was cited for the same violation on 4/12/2024, for violation of 101223 (a)(2) Personal Rights. A civil penalty of $250 was assessed for a repeated violation within 12 months.

Per Director and a new procedure regarding infant feedings was implemented and discussed with each staff. Director stated that only designated staff will be allow to provide bottle feedings and each staff will conduct a name to face of each child prior to bottle feedings. Based on interviews, one (1) Type B deficiency of California Code of Regulations, Title 22, Division 12, Chapter 1, is being cited. See the attached LIC 809D.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/28/2024 04:15 PM - It Cannot Be Edited


Created By: Vicky Williamson On 06/28/2024 at 03:37 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEARNING JUNGLE RANCHO SAN DIEGO - INFANT
FACILITY NUMBER: 376701504

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/26/2024
Section Cited
CCR
101223(a)(2)

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Personal Rights. (a)The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and… accommodations... to meet his/her needs.
This requirement is not met as evidenced by:
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Director stated that staff will receive training on bottle feeding procedures and personal rights by an outside agency. Director stated that she will submit the training agenda, summary of training and staff sign in sheet to the SDRO, no later than 7/26/24.
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Based on interview and record review, the licensee did not comply with the section cited as S2 gave C1 two sips of a breastmilk bottle belonging to C2 which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tulam Vu
LICENSING EVALUATOR NAME:Vicky Williamson
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2024


LIC809 (FAS) - (06/04)
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