376701504-9-6-2023-20-CC-VWIN-CVEQRF-20230906122352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701504
Report Date: 09/06/2023
Date Signed: 09/06/2023 12:23:56 PM

Document Has Been Signed on 09/06/2023 12:23 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	LEARNING JUNGLE RANCHO SAN DIEGO - INFANT		FACILITY NUMBER:	376701504
ADMINISTRATOR:	TINA PROWANT		FACILITY TYPE:	830
ADDRESS:	3605 AVOCADO BOULEVARD		TELEPHONE:	(619) 569-7607
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 37	CENSUS: 29	DATE:	09/06/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	11:01 AM
MET WITH:	Kristen Beltran		TIME COMPLETED:	12:40 PM

NARRATIVE

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On 9/6/2023, at 11:01am., Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection regarding a self - reported incident. LPA met with Assistant Director, Krizia Beltran. LPA discussed the purpose of the inspection and was led on a tour of the facility. The following ratios were observed: Room 1 had six children present with two staff, Room 2 were observed on the playground with four children and two staff, Room 3 had 10 children (ages 18 - 36 months) with two staff, Room 4 had nine children (ages 18 - 36 months) present with two staff.

On 7/20/2023, the director self- reported an incident involving Child #1 (C1) [See Confidential Names]. Per Assistant Director, the alleged incident occurred on 7/20/2023 at around 11:33am.

Assistant Director reported that Staff #1 (S1) [See Confidential Names] was observed handling C1 in an abrupt manner. Interviews were conducted with assistant director, staff members and outside agencies. C1 and their authorized representative were unavailable for interview.

A review of facility records for S1 was reviewed. LPA’s review of video footage determined that C1 was handled in an abrupt manner by S1 on three (3) different occasions throughout the video: S1 was observed sitting C1 down on the carpet area in the classroom and holding him in the crease of both elbows abruptly; S1 was also observed grabbing C1 by both elbows abruptly and sitting him on his bottom on the carpet area in the classroom; S1 grabbed C1 by the crease of both elbows and pulled him down to the carpet. Based on interviews and video footage, S1 violated the personal rights of C1. S1 is no longer an employee at the facility.

Assistant Director stated that a training regarding the personal rights of children will conducted with all staff.

Based on interviews and video footage, one (1) Type A deficiency of California Code of Regulations, Title 22, Division 12, Chapter 1, is being cited on the attached LIC 809D. See LIC 809C Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEARNING JUNGLE RANCHO SAN DIEGO - INFANT	FACILITY NUMBER: 376701504
	VISIT DATE: 09/06/2023

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LPA informed Assistant Director, Krizia Beltran that this report dated 9/6/2023 documents one (1) Type A citation, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA informed Assistant Director to provide a copy of this licensing report dated 9/6/2023 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. LPA provided Assistant Director, Krizia Beltran wiith form LIC 9224.

An exit interview was conducted with Assistant Director, Krizia Beltran, a copy of this report along with the Appeals Rights (LIC 9058) was provided. A Notice of Site Visit is provided and required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed Assistant Director post Notice of Site Visit to the door at the entrance.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/06/2023 12:23 PM - It Cannot Be Edited

Created By: Vicky Williamson On 09/05/2023 at 12:58 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEARNING JUNGLE RANCHO SAN DIEGO - INFANT	FACILITY NUMBER: 376701504
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/25/2023 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	101223(a)(1) Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Assistant Director stated that S1 resigned on 7/21/2023. Asst. Director stated that staff will be retrained on personal rights and view the video Children's Personal Rights in Child Care on the CCLD website and submit a summary of the video,staff sign in sheet and also a written plan of correction to the
	8 9 10 11 12 13 14	Based on interview and record review, the licensee did not comply with the section cited above as the personal rights of C1 were not accorded as S1 handled C1 in an abrupt manner on three (3) separate occassion, which poses a immediate health, safety, or personal rights risk to persons in care.	8 9 10 11 12 13 14	SDRO by 9/25/2023.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Tulam Vu

LICENSING EVALUATOR NAME:

Vicky Williamson

LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

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