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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300053
Report Date: 11/28/2022
Date Signed: 11/28/2022 01:53:22 PM

Document Has Been Signed on 11/28/2022 01:53 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LEARNING JUNGLE ESCONDIDO EASTFACILITY NUMBER:
376300053
ADMINISTRATOR:POLK, SUSANFACILITY TYPE:
830
ADDRESS:1851 E WASHINGTONTELEPHONE:
(760) 745-0115
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 10DATE:
11/28/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria Isabel GutierrezTIME COMPLETED:
02:15 PM
NARRATIVE
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On date and time listed, Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility to conduct a visit for a different purpose. However, during the visit on 11/28/22 staff files were reviewed, and it was observed that S2 and S5 had not renewed their Mandated Reporter Training.

See LIC 809D for deficiency cited.

An exit interview was conducted, appeal rights were given and discussed, and a copy of this report and Notice of Site Visit was provided to the Facility Representative. The Notice of Site Visit must be posted in a prominent location for the next 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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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Document Has Been Signed on 11/28/2022 01:53 PM - It Cannot Be Edited


Created By: Sumayya Habeebulla On 11/28/2022 at 01:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEARNING JUNGLE ESCONDIDO EAST
FACILITY NUMBER: 376300053

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2022
Section Cited
HSC
1596.8662(b)(1)

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(1) On or before March 30, 2018, a person who... a licensed child day care provider... shall complete renewal mandated reporter training every two years...
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 >>> the section cited above in requiring S2 and S5 renewing their Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
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This requirement is not met as evidenced by:

Based on interview and record review, facility did not comply with >>>
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 Facility Representative agrees to renew her and the Assistant's Mandated Reporetr Training and submit the proof to the Department by teh POC due date.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Carlos Martinez
LICENSING EVALUATOR NAME:Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2022


LIC809 (FAS) - (06/04)
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