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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600627
Report Date: 12/15/2020
Date Signed: 07/28/2021 10:49:15 AM

Document Has Been Signed on 07/28/2021 10:49 AM - 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:JEFF & DENI JACOBS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376600627
ADMINISTRATOR:ANNE PATZOLDFACILITY TYPE:
850
ADDRESS:2360 EAST JEWETT STREETTELEPHONE:
(858) 278-2571
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY: 144TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
12/15/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Annie PatzolzTIME COMPLETED:
10:35 AM
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On 12/15/2020 at 10:20 AM, Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced Case Management Inspection due to a reported positive case of COVID-19 at this facility. Due to COVID-19, this inspection was conducted telephonically. LPA Sutherland spoke with Director Annie Patzolz. The facility was closed on 12/14/20. A full facility inspection was not conducted today.

Director has called the Department of Public Health and Epidemiology and is waiting for call back.

Director states positive staff members last day worked was on 12/11/20, tested on 12/13/20 and positive results were given on 12/14/20. When Director was made aware of the positive COVID case, she immediately closed her facility and has a reopen date of 12/28/20. Child #1 went home early on 12/11/20 with fever, child #1 was tested and had negative results.


No deficiencies are cited.

An exit interview was conducted with the Director. The Director was provided a copy of their appeal rights, this report, and the Notice of Site Visit via email. Director will respond to the email confirming receipt of these items. This will act as Director’s signature on today’s inspection report. Notice of Site Visit will remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2020
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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