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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093610400
Report Date: 12/05/2024
Date Signed: 12/05/2024 01:26:44 PM

Document Has Been Signed on 12/05/2024 01:26 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:AL TAHOE SCHOOL HEAD STARTFACILITY NUMBER:
093610400
ADMINISTRATOR/
DIRECTOR:		GUTIERREZ, ROSAFACILITY TYPE:
850
ADDRESS:1100 LYONS AVE. #C5-8TELEPHONE:
(530) 541-0284
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 103TOTAL ENROLLED CHILDREN: 103CENSUS: 39DATE:
12/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:05 PM
MET WITH:Rosa GutierrezTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On December 5th, 2024, Licensing Program Analyst (LPA) Soleil Marx, met with Facility Representative, Rosa Gutierrez, for an unannounced case management inspection for the purpose of inspecting a newly manufactured play structure in the outdoor activity space.

LPA observed a census of 39 preschool age children being supervised by ten staff in classrooms C6, C7, C8, and the portable. C5 is not currently being utilized by children.

LPA observed newly manufactured play structure has replaced the old play structure, but remains in the prior approved outdoor activity space, which is fully enclosed by a fence that is at least four feet tall and has approved footage for the current capacity. LPA observed the play structure to be age appropriate for the preschool facility with a manufacturer label stating equipment is designed for ages 2-5. LPA observed outdoor activity space to be free of hazards and in safe condition for children to utilize. LPA observed equipment and activity areas are arranged so that there is no hazard from conflicting activities. LPA observed shaded areas are available to children by awnings which are stored away for winter snow conditions. LPA observed an adequate amount of wood chips as cushioning under climbing equipment to absorb a fall; LPA provided consultation regarding using caution utilizing climbing equipment if wood chips are frozen as that would not be sufficient material for absorbing a fall.

LPA has approved the new play structure for children to utilize effective immediately.

Exit interview conducted and report was reviewed with the Facility Representative, Rosa Gutierrez. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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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