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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817504
Report Date: 09/23/2021
Date Signed: 09/23/2021 02:52:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:JUMPSTART, LEARNING CENTER, INC.FACILITY NUMBER:
364817504
ADMINISTRATOR:MIREYA GOMEZFACILITY TYPE:
840
ADDRESS:10213 BASELINE ROADTELEPHONE:
(909) 373-1831
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:28CENSUS: 16DATE:
09/23/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:Mireya Gomez/DirectorTIME COMPLETED:
03:20 PM
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On 9/23/2021 at 12:30 PM Licensing Program Analyst (LPA) Patricia Berry conducted a case management/incident investigation. LPA was granted access into the facility and met with director. LPA toured facility and took a census. Director self reported that on 9/15 at approximately 1:30-2:00 PM, a child cut a another child's backpack with a razor blade while on the van. Child 2 stated, child 1 had a razor blade in the pocket of the pants. Child 2 stated, that child 1 cut the strap of the backpack of child 2. Child 2 stated the backpack was not placed up front with the other backpacks. Child 2 stated, child 1 told child 2 not to say anything to the teachers. Staff stated the policy for the Van is for the van driver to put all backpacks at the front of the van as children enter the van. Staff stated the van driver does not do any type of backpack check or body check before entering the van. Staff stated the van driver was not aware of the incident because the van driver was driving. Staff also stated child 2 did not say anything about the incident until child 1 went home.

The van driver is responsible for driving the van and cannot observe all things while driving, the backpacks are placed in the front of the van, child 2 did say child 1 had a razor blade, however child 1 denied having a razor blade as stated to assistant director.

Based on the information obtained there has been no violation of Title 22 regulations.

Exit interview conducted with director and report given.


LPA observed director post Notice of Site Visit.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
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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