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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701506
Report Date: 05/01/2026
Date Signed: 05/01/2026 02:52:37 PM

Document Has Been Signed on 05/01/2026 02:52 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LEARNING JUNGLE ADAMS AVENUE - INFANTFACILITY NUMBER:
376701506
ADMINISTRATOR/
DIRECTOR:		FRANCISCA LUMABANFACILITY TYPE:
830
ADDRESS:3844 ADAMS AVENUETELEPHONE:
(619) 301-7025
CITY:SAN DIEGOSTATE: CAZIP CODE:
92116
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 15DATE:
05/01/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Francisca LumabanTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 05/01/2026 at 10:10 AM, Licensing Program Analyst (LPA), Dana Stevens, conducted an unannounced Case Management Inspection to follow up on an Unusual Incident. LPA met with Director, Francisca Lumaban, and informed her of the reason for the visit. There were 15 children present with 5 staff during this inspection.

On 03/27/2026, the Department received an Unusual Incident Report (LIC624) submitted by Director, reporting an incident that occurred on 03/26/2026. Director reported that on 03/26/2026, on the Infant playground, two children were unsupervised for a period of 47 seconds, during this time one child bit the other child 6 times, one bite resulting in broken skin.

During the Unusual Incident review, LPA toured facility, conducted interviews with the Director and staff, and reviewed photo and video footage.

Based on information obtained in interviews and video footage review, it was determined that on 03/26/2026, at or around 4:34 PM, there were 7 children on the Infant playground with 3 teachers. Child 1 (C1) and Child 2 (C2) ran to the other side of the playground where no staff or other children were present. Based on review of video footage, C1 and C2 were unsupervised for approximately 44 seconds. During the 44 seconds C1 climbed onto C2's back and bit C2 six times. At approximately 04:34:54, Staff 4 (S4) intervened and removed C1 from C2's back. C2 was taken to Director's office where C2 was examined and provided with first aid. C2 was found to have a total of six (6) bite marks, one of which broke the skin. Director reported the incident to the parents of C1 and C2 the same day.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LEARNING JUNGLE ADAMS AVENUE - INFANT
FACILITY NUMBER: 376701506
VISIT DATE: 05/01/2026
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Per California Code of Regulations, (Title 22, division 12 & Chapter 1) one (1) Type A citation is being cited on the attached LIC 809-D.

LPA Stevens informed Director that this report dated 05/01/2026 document(s) one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Stevens informed the Director to provide a copy of this licensing report dated 05/01/2026 that documents the 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.

Exit interview conducted and copy of this report and appeal rights provided to Director. Notice of site visit must be posted for thirty (30) days.
NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/01/2026 02:52 PM - It Cannot Be Edited


Created By: Dana Stevens On 05/01/2026 at 02:22 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 ADAMS AVENUE - INFANT
FACILITY NUMBER: 376701506

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/08/2026
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1)No child(ren) shall be left without the supervision of a teacher at any time,
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During visit, Director provided proof of training on Continuous Supervison of Children provided during an All-Staff meeting held on 04/03/2026. Director will also provide a written plan that details steps the facility will take to try to prevent future biting incidents.
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Supervision shall include visual observation. This requirement was not met as evidenced by, based on interviews and video footage review, the facility did not comply with the section cited above, when C1 and C2 were left unsupervised on the Infant Playground for 44 seconds resulting in C1 biting C2 six times, which posed an immediate Health, Safety and/or Personal Rights risk for children in care.
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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.
Rajani Goudreau
NAME OF LICENSING PROGRAM MANAGER:
Dana Stevens
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/01/2026


LIC809 (FAS) - (06/04)
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