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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701508
Report Date: 04/10/2023
Date Signed: 04/10/2023 06:37:02 PM

Document Has Been Signed on 04/10/2023 06:37 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: 12CENSUS: 8DATE:
04/10/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Jacquelyn Aguigui-FajardoTIME COMPLETED:
05:12 PM
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On 4/10/23 at 4:00pm, Licensing Program Analyst (LPA), Martha Malane conducted a follow-up case management inspection for the purpose of a capacity increase. Upon arrival, LPA met with Director, Jacquelyn Aguigui-Fajardo and was led on a tour of the facility. There were eight (8) children and three (3) staff members present. The facility is requesting a capacity increase to 17 infant children, age 6 weeks – 24 months in the infant room. Hours of operation are Monday – Friday 7:00am to 5:30pm.

The indoor space was inspected and measured a total of 574.12 square feet which is sufficient to accommodate 16 children.

The outdoor activity space was inspected and previously measured a total of 1027.40 square feet which is sufficient to accommodate 13 children.

A fire clearance for 17 infant children, age 6 weeks - 24 months was granted 2/13/23.

The following is required:


· Submit waiver request for outdoor activity space due to insufficient space
· Updated LIC200A to reflect the requested capacity

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies were cited. Exit interview conduct with Director, Jackie Aguigui-Fajardo. Notice of Site Visit shall be posted for 30 days from today's date. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2023
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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