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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701508
Report Date: 01/03/2022
Date Signed: 01/03/2022 11:58:06 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:15CENSUS: 0DATE:
01/03/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Letitia AriasTIME COMPLETED:
12:20 PM
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On 01/03/22 at 11:01 a.m., Licensing Program Analyst (LPA), Rajani Goudreau arrived at the facility to conduct a pre-licensing inspection to deliver amended reports originally created on 12/31/21. Upon arrival LPA, met with Licensee Representative, Letitia Arias and proceeded to tour the facility.

First aid kit reviewed and complete with the required supplies. Also, reviewed and approved the plan of operation for the transition of the infants to and from the outdoor activity space.

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 and the review, a license will be issued for 13 infants; ages 6 weeks through 2 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
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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