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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105085
Report Date: 09/19/2022
Date Signed: 09/19/2022 05:27:46 PM

Document Has Been Signed on 09/19/2022 05:27 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LEARNING JUNGLE MISSION VALLEYFACILITY NUMBER:
376105085
ADMINISTRATOR:KENDRA DEGROOTFACILITY TYPE:
830
ADDRESS:403 CAMINO DEL RIO SOUTHTELEPHONE:
(619) 309-3430
CITY:SAN DIEGOSTATE: CAZIP CODE:
92108
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 20DATE:
09/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
05:16 PM
MET WITH:Dolores GuadarramaTIME COMPLETED:
05:35 PM
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On 9/19/22 at 5:16 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management visit in regards to a self-reported unusual incident that happened at the facility on 7/26/22. LPA interviewed Director and one staff member. However, staff member that witnessed the incident was not at the facility at time of inspection. Due to insufficient information at this time, the incident needs further investigation.

No deficiencies were cited at this inspection.

Exit interview conducted and report was reviewed with the facility representative Dolores Guadarrama. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2022
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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