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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093624376
Report Date: 08/03/2022
Date Signed: 08/03/2022 01:37:39 PM

Document Has Been Signed on 08/03/2022 01:37 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:LTUSD INFANT PROGRAMFACILITY NUMBER:
093624376
ADMINISTRATOR:SALAZAR, ANDREAFACILITY TYPE:
830
ADDRESS:1100 LYONS AVENUETELEPHONE:
(530) 541-2850
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
08/03/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Annamarie CohenTIME COMPLETED:
01:50 PM
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At 10:30AM on Wednesday, August 3, 2022, Licensing Program Analysts (LPAs) Arianna Manabat and Mandie Goodwin and Licensing Program Manager (LPM) Natalie Dunaway met with Facility Representative, Annamarie Cohen, for the purpose of an announced change of location (previous license 093622073). During today's visit there were no children in care. The facility's current hours of operation are Monday through Friday from 7 AM to 5 PM.

A health and safety inspection was conducted in all areas accessible to children.. LPAs advised that the tables and chairs should be suitable for infant sized children.

The total square footage for the usable infant license is 551.4 ft in classroom P-1. LPAs did NOT include the napping area within the square footage. The center is licensed for 4 infants under 12 months and 8 infants 12-24 months.

LPAs observed the outdoor play area is fenced and equipped with a sufficient amount of play equipment and toys. The outdoor space measures 2,291 sqft which will accommodate the infant children. There is sufficient resilient material underneath climbing structures to absorb a fall.

Prior to licensor the following must be completed;
1. A waiver submitted for sharing the outdoor playground for both licenses.
2. Pictures of the infant space with the furniture and equipment.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection. Notice of Site was provided and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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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