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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701508
Report Date: 12/14/2022
Date Signed: 12/14/2022 03:38:02 PM

Document Has Been Signed on 12/14/2022 03:38 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. - INFANT/TODDLERFACILITY NUMBER:
376701508
ADMINISTRATOR:JACQUELYN AGUIGUI-FAJARDOFACILITY TYPE:
830
ADDRESS:2705 VIA ORANGE WAY, SUITE ATELEPHONE:
(619) 303-1541
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY: 13TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
12/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Jacquelyn Aguigui-Fajardo TIME COMPLETED:
10:45 AM
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On 12/14/2022 at 10:20am, Licensing Program Analysts (LPAs), David Miller and Vicky Williamson conducted an unannounced case management inspection in order to deliver an amended report originally created on 12/01/2022. Upon arrival LPA met with the Director, Jacquelyn Aguigui-Fajardo and explained the purpose of the inspection. There were seven (7) infants with three (3) staff present during the inspection.

No deficiencies cited.

Exit interview was conducted with the Director, Jacquelyn Aguigui-Fajardo. Notice of Site (NOS) visit was given and must remain posted for 30 days. LPA observed the Director post the NOS on the bulletin board. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2022
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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