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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701507
Report Date: 05/09/2023
Date Signed: 05/09/2023 02:43:40 PM

Document Has Been Signed on 05/09/2023 02:43 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:JUMP PRESCHOOL INC.FACILITY NUMBER:
376701507
ADMINISTRATOR:JACQUELYN AGUIGUI-FAJARDOFACILITY TYPE:
850
ADDRESS:2705 VIA ORANGE WAY, SUITE ATELEPHONE:
(619) 303-1541
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY: 20TOTAL ENROLLED CHILDREN: 35CENSUS: 32DATE:
05/09/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:TIME COMPLETED:
03:00 PM
NARRATIVE
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On 05/09/2023 at 01:30 pm Licensing Program Analysts (LPA), David Miller conducted an unannounced case management deficiency inspection. Upon arrival, LPA met with Director, Jacquelyn Aguigui-Fajardo and disclosed purpose of the inspection. The following ratios were observed:

Classroom #2 is designated as the TK/K classroom and had twenty (20) childcare children between the ages of 4-5.
The preschool classroom had twelve (12) children between the ages of 2-3 and two (2) staff

The license is currently licensed for twenty (20) children. However, LPA observed twenty (20) children in the TK/K classroom and twelve (12) children in the preschool classroom. The TK/K classroom is licensed and part of the preschool facility #376701507.

Thus, LPA Miller observed that facility is operating over capacity in having 32 children on this date. See LIC809D. Staff in the TK/K classroom stated there were 20 children and staff in the preschool classroom stated there were 12 children. The Director stated that both classrooms have been operating since approximately April 18th, 2023 above the capacity of twenty total children.

LPA Miller informed Director, Jacquelyn Aguigui-Fajardo that this report dated 05/09/2023 documents a Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JUMP PRESCHOOL INC.
FACILITY NUMBER: 376701507
VISIT DATE: 05/09/2023
NARRATIVE
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Also, LPA informed the Director that the report dated 05/09/2023 that documents any Type A citation to provide a copy 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.

LPAs provided Director, Jacquelyn Aguigui-Fajardo with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days.  LPA observed form LIC 9213 posted on the bulletin board at the entrance.  Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted with the Director, who was provided a copy of their Licensee Appeal Rights LIC 9058.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/16/2023 04:48 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 05/10/2023 04:23 PM


Created By: David Miller On 05/09/2023 at 01:57 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: JUMP PRESCHOOL INC.
FACILITY NUMBER: 376701507

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/09/2023
Section Cited
CCR
101161(a)

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101161 Limitations on Capacity
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement is not met as evidenced by:
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Director states she will disuss the deficiency with the owner to clarify capacity. In addition, Director stated that she will close a classroom to ensure the facility maintains capacity. Director states she will let the parents know and will send the department a copy of the LIC9224 letter provided to parents.
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Based on observation, record review, and interviews, the licensee did not comply with the section cited above in that there were 32 children in attendance, which poses an immediate Health and Safety and Personal Rights risk to persons in care.
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*This is an amended version of an original report created on 5/9/23

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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:Tulam Vu
LICENSING EVALUATOR NAME:David Miller
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2023


LIC809 (FAS) - (06/04)
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