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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701044
Report Date: 10/15/2021
Date Signed: 10/15/2021 11:47:24 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LEARNING JUNGLE SCHOOL - SAN MARCOS CAMPUSFACILITY NUMBER:
376701044
ADMINISTRATOR:CASSANDRA LOVITTFACILITY TYPE:
830
ADDRESS:1364 EAST MISSION ROADTELEPHONE:
(760) 432-8050
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:12CENSUS: 8DATE:
10/15/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Director Cassandra LovittTIME COMPLETED:
11:50 AM
NARRATIVE
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On 10/15/2021 @ 11:15 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on a self-reported incident that occurred on 10/8/21 wherein an infant (Child #1) fell from the changing table.

During this visit, LPA observed the area of the changing table and spoke with the Director and Staff #2. Staff #1 was not present today but provided a written statement of events. LPA also reviewed correspondence from the parent of Child #1.

Based on the information received, Staff #1 was standing right at the changing table at the time of the incident. When looking away briefly to reach down and pull out a diaper from a box stored inside the changing table, Child #1 slipped off, between the staff and the changing table, through a small opening in the barrier, falling to the laminate floor. Child #1 sustained a small bump to the back of the head and the facility provided first aid while the parent was contacted. Child #1 was evaluated by a physician later that day, cleared of any injury requiring additional attention and returned to care the following Monday.

Although Staff #1 was standing right at the changing table and the changing table meets regulatory requirement, Staff #1 did not have direct hands on Child #1 and had not secured the child to the changing table, this situation could have been avoided. Therefore, a Type B deficiency will be cited on the accompanying LIC 809D as a potential hazard to children in care.

Notice of Site visit was given and will remain posted for 30 days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: LEARNING JUNGLE SCHOOL - SAN MARCOS CAMPUS
FACILITY NUMBER: 376701044
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2021
Section Cited

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Infant Care Personal Services...When changing an infant's diapers, the following shall apply:...No infant shall be left unattended while on a changing table.

This requirement was not met as evidenced by:
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Based on observation, interview and review of staff statements, although Staff #1 was standing at the changing table,Child #1 was briefly unattended while Staff #1 looked away to find a diaper, allowing for Child #1 to slip off and fall to the floor. This is a potential hazard to children in care should this not be corrected.
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meeting held this month and supervision at the changing table will be added to the agenda. A copy of the agenda and roster will be sent to licensing as proof of correction. Director also states that she is looking for a safe barrior, such as mesh, to block the opening of the changing table and adding cushioning on the floor as extra precaution.

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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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2021
LIC809 (FAS) - (06/04)
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