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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374844881
Report Date: 11/10/2022
Date Signed: 11/10/2022 12:54:37 PM


Document Has Been Signed on 11/10/2022 12:54 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:LEAPS AND BOUNDSFACILITY NUMBER:
374844881
ADMINISTRATOR:KORNICZUK, SARAHFACILITY TYPE:
840
ADDRESS:270 WEST CREST STREETTELEPHONE:
(408) 420-1682
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:34CENSUS: 0DATE:
11/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:23 PM
MET WITH:Lianne Holgate, DIrectorTIME COMPLETED:
01:00 PM
NARRATIVE
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On November 10, 2022 at 12:24 PM, Licensing Program Analyst (LPA) Cindy Hamilton met with Director Lianne Holgate, in regard to an observation made by LPA during an October 13, 2022 complaint inspection. During inspection on 10/13/22, LPA Hamilton observed two ripped, stained, brown couches in the school age area. One of the couches' wood frame is exposed through a hole on the arm of the couch. LPA also observed other holes exposing the inside of the couch. LPA Hamilton took pictures of the couches on 10/13/2022 and 11/10/2022 and advised Director couches are a hazard to children in care.

Based on observation, facility is being cited for 101239(n) Fixtures, Furniture, Equipment and Supplies . This poses a potential health and safety risk to children in care

A copy of this report, LIC 809-D, appeal rights were explained and provided to Director. Director was provided with a Notice of Site Visit and reminded the notice must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy HamiltonTELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022
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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Document Has Been Signed on 11/10/2022 12:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: LEAPS AND BOUNDS
FACILITY NUMBER: 374844881

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2022
Section Cited

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101239 (n) Fixtures, Furniture, Equipment and Supplies Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts. This requirement was not met as evidenced by:


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Based on observations the facility has a classroom with two dirty, and torn brown couches that have holes exposing the woodframe on the arm of one of the couches which poses a potential health, safety and/or personal rights risk to children 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: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy HamiltonTELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022
LIC809 (FAS) - (06/04)
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