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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701508
Report Date: 12/31/2021
Date Signed: 01/03/2022 11:59:20 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:JUMP PRESCHOOL INC.FACILITY NUMBER:
376701508
ADMINISTRATOR:JACQUELYN AGUIGUI-FAJARDOFACILITY TYPE:
830
ADDRESS:2705 VIA ORANGE WAY, SUITE ATELEPHONE:
(619) 303-1541
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY:20CENSUS: 0DATE:
12/31/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Letitia AriasTIME COMPLETED:
12:30 PM
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This is an amended version of the original report created on 12/31/21.
On 12/31/21 at 10:30 a.m., Licensing Program Analyst (LPA), Rajani Goudreau arrived at the facility to conduct a pre-licensing inspection. Upon arrival LPA, met with Licensee Representative, Letitia Arias and proceeded to tour the facility. The facility is requested a capacity of 13 infants; serving ages 6 weeks through 2 years old. This infant program will operate in the infant/toddler classroom #2. Facility plans to operate Monday through Friday from 7:30 a.m. to 5:30 p.m.

The following classroom was inspected and measured during this inspection:

  • The classroom measured a total of 494.91 square feet.

The indoor space for infants measured a total of 494.91 square feet which is sufficient to accommodate 14 infant children. The classroom is equipped with age appropriate furniture, including cots and cribs for napping, tables, chairs, cubbies, bookshelves and other play materials for the children’s use. The classroom has adequate heating, lighting and ventilation. The classroom is clean and orderly and are free of hazards. The classroom has a separate area for napping, including cribs and a chair. Crib mattresses and cots are maintained and in safe condition. The napping area was not included in the indoor square footage calculation. There is a restroom in the classroom containing two sinks and two toilets exclusive for the children’s use. There is a sink within arm’s reach of the changing table in the restroom. The infant table is padded with washable vinyl at least one inch thick with sides raised at least 3 inches. The director understands the sink near the diaper changing table shall not be used for food preparation. There are sufficient potty chairs and sinks available for the children’s use based on the requested capacity. The feeding tables for infants are in good repair and made of a washable, moisture resistant material. All hazardous items; including disinfectants, cleaning solutions are stored where they are inaccessible to children. Director stated drinking water will be available to the children in care inside and outside via refillable water containers and sippy cups. See LIC809-C continuation page...
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 12/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/31/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: JUMP PRESCHOOL INC.
FACILITY NUMBER: 376701508
VISIT DATE: 12/31/2021
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This is an amended version of the original report created on 12/31/21.

There is a separate restroom for staff located in the church area of the building. The director’s office will be utilized as an isolation area, if a child becomes ill. The isolation area shall be equipped with a crib, cot or playpen for each ill infant. In addition, infants in the isolation shall be under constant visual observation. There is a carbon monoxide detector in the classroom and a first aid kit with required supplies. Uncontaminated drinking water is readily available during indoor and outdoor activities through the use of refillable water containers and refillable water cups brought from home. Required documents are posted.

The outdoor activity space for the infants was inspected and measured a total of 1,027.40 square feet which is sufficient to accommodate 13 infant children. Applicant has agreed to lower the requested capacity to 13 children due to limited outdoor space. Updated LIC200A received at time of visit. The outdoor space is located in the far east side of the parking lot. Also, the children will have to go through the church area to access the outdoor activity space. Applicant will submit a plan of operation to ensure supervision is maintained during the transition of children to and from the outdoor activity space. The infant program has exclusive use of the outdoor activity space. The outdoor activity space is enclosed by a fence that is at least four feet high. There is a shaded rest area for the children by the use of shade kites. The outdoor activity space is free of hazards. The outdoor activity space is equipped with age appropriate play equipment and toys. There are no climbing structures present in the infant outdoor activity space. Proper supervision and placement of staff outside was discussed to ensure the safety of children at all times.

This facility provides Incidental Medical Services - IMS. IMS plan submitted and approved. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA discussed California Megan's Law: www.meganslaw.ca.gov.LPA and director discussed, and LPA provided the following resources: Lead Positioning Brochure, Shaken Baby Syndrome and PIN 20-24-CCLD regarding Safe Sleep Regulations in Effect.

A fire clearance was granted on December 27, 2021 for 15 infants. An updated fire clearance will be requested due to the updated capacity request from 15 to 13 children.

See LIC809-C continuation page...

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: JUMP PRESCHOOL INC.
FACILITY NUMBER: 376701508
VISIT DATE: 12/31/2021
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This is an amended version of the original report created on 12/31/21.

The following is pending with a due date of January 03, 2022:

· Playground waiver request


· Plan of operation for the transition of the infants to and from the outdoor activity space.
· First Aid kit with the required supplies .

An exit interview was conducted with Licensee Representative, Letitia Arias. The following reports were discussed and provided: LIC809 and Appeal Rights (LIC9058). Once the the pending documents are received, after final file review, a license will be issued for 13 infants; ages 6 weeks through 2 years old in the infant/toddler classroom #2.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
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