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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701157
Report Date: 10/29/2020
Date Signed: 10/29/2020 12:09:52 PM

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 - LA MESA CAMPUSFACILITY NUMBER:
376701157
ADMINISTRATOR:AMANDA LUNDYFACILITY TYPE:
830
ADDRESS:7484 UNIVERSITY AVENUE STE 100TELEPHONE:
(619) 589-9196
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY:12CENSUS: 10DATE:
10/29/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Amanda Lundy, Facility DirectorTIME COMPLETED:
10:52 AM
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On October 29, 2020 at 10:43 AM Licensing Program Analyst (LPA), Marie Hernandez, conducted an unannounced Tele-Conference Case Management Inspection due to the COVID -19 State of Emergency via WhatsApp with the Director, Amanda Lundy. This is to conclude the incident review of 10/28/2020. On 10/28/2020, the facility self reported the incident to the Department. The facility reports that on 10/28/2020 at 10:00 AM, a year old child #1 was playing on the soft play structure in the classroom and became unconscious. The child was still breathing but was unresponsive for one to two minutes. 911 and the parent were immediately contacted. However, the child became conscious but lethargic so the teacher sat with child for observation until the paramedics arrived. Through the course of the incident review, LPA inspected the infant room area where the incident occurred and conducted several interviews with the staff, Director, and parent. The children could not be interviewed as they are infants and nonverbal. On the day of the incident, there were six infants with two staff. The staff stated the child was playing on the soft play structure when child suddenly fainted on the soft play structure. The staff stated at time of incident, the child did not land on the floor or hit his head on any object. The staff stated the child was unresponsive for one to two minutes but was still breathing. The staff stated she immediately tended to child’s needs and sat with child until the paramedics arrived. The parent stated the child is fine with no further incident. The parent stated the child did not sustain any bruising or injury. The parent stated the staff handled the incident appropriately and that parent does not have any concerns pertaining to the staff and the center (facility) at this time. The child returned to the facility today with no further incident. This concludes the incident review. No deficiency cited.

LPA Marie Hernandez explained the case management incident inspection report, and the Director stated she understood. An exit interview was conducted, and a copy of the report was emailed to the Director. The Director was advised that acknowledgement of the receipt of the report is to be received within 24 hours. NOTE on Facility Signature: SEE FILE FOR ACKNOWLEDGEMENT.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020
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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