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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500314
Report Date: 04/13/2022
Date Signed: 04/13/2022 12:02:58 PM


Document Has Been Signed on 04/13/2022 12:02 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:LEARNING JUNGLE WEST SACRAMENTOFACILITY NUMBER:
574500314
ADMINISTRATOR:DE'ANGELA REEDFACILITY TYPE:
840
ADDRESS:2475 HIGGINS ROADTELEPHONE:
(312) 493-1570
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY:30CENSUS: 20DATE:
04/13/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:De'Angela ReedTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Erwin Tjhia and Licensing Program Manager (LPM) Bettina Engelman met with Director, De'Angela Reed and Assistant Director, Briana Esquivel, to follow up on two different Unusual Incident Reports (UIRs) submitted to Community Care Licensing on 03/31/2022. During today's visit the licensing staff toured the facility, observed care and supervision of children, and reviewed records.

Licensing staff interviewed the Director and staff members who were present during the incidents.

No deficiency was cited during today's visit.

Facility evaluation report was reviewed and discussed with the director. An Exit interview was conducted. A Notice of Site Visit was posted by licensing staff and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin TjhiaTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2022
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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