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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 173000812
Report Date: 09/02/2025
Date Signed: 09/02/2025 02:55:46 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/20/2025 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20250820101601
FACILITY NAME:LAKEPORT CHRISTIAN CENTER PRESCHOOLFACILITY NUMBER:
173000812
ADMINISTRATOR:PAARSCH, MARYFACILITY TYPE:
850
ADDRESS:175 C STREETTELEPHONE:
(707) 262-5520
CITY:LAKEPORTSTATE: CAZIP CODE:
95453
CAPACITY:45CENSUS: 7DATE:
09/02/2025
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Site Supervisor, Michelle WalkerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Child left unattended in a room.
INVESTIGATION FINDINGS:
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A subsequent complaint investigation visit was conducted today by Licensing Program Analyst (LPA), Sebastian Phouthavong who met with the Site Supervisor, Michelle Walker (SS) for the purpose of delivering complaint investigation finding for the above allegation. LPA previously conducted an inspection on 08/28/2025 to initiate the investigation and met with Admin Manager, Ruth Suski to discuss the allegation. It was alleged that a child was left unattended in a room.

During the course of the investigation on 09/02/2025, LPA conducted interviews with the Site Supervisor (SS), one staff (S1) and four daycare children (C2-C5). SS and S1 confirmed that an incident occurred where one child was left attended inside the facility’s nap room while the reminding children and staff would outside at play yard. Additionally, SS stated the child was left unattended for roughly fifteen minutes.

(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Mohr
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 01-CC-20250820101601
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: LAKEPORT CHRISTIAN CENTER PRESCHOOL
FACILITY NUMBER: 173000812
VISIT DATE: 09/02/2025
NARRATIVE
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(Continued from LIC9099)

Based on the information gathered during this investigation, the preponderance of the evidence standard has been met. Therefore, the allegation is determined to be substantiated. Health & Safety Code 1597.58(c)(2) is being cited on the attached LIC 9099-D resulting in an immediate civil penalty of $500 for absence of supervision. Appeal rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently enrolled by the next business day or the next day the children are in care, and to parents/guardians of children newly enrolled at the facility for the next 12 months from the date of this report. Parents/guardians must sign Form LIC 9224 to be kept in each child's file.
SUPERVISORS NAME: Melinda Mohr
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 01-CC-20250820101601
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LAKEPORT CHRISTIAN CENTER PRESCHOOL
FACILITY NUMBER: 173000812
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/03/2025
Section Cited
HSC
1597.58(c)(2)
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HSC 1597.58(c)(2) Absence of supervision, including, but not limited to, a child left unattended, and a child left alone with a person under 18 years of age. This requirement is not met as evidenced by:
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The Site Supervisor will submit a written plan to the department, detailing steps that have been implemented to comply with supervision requirements, including staff trainings and updates to staff awareness to prevent a reoccurrence of an absence or lack of supervision.
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Based on interviews conducted by SS and S1, a child was left unattended inside the nap room. This poses an immediate health and safety risk to children in care. A civil penalty of $500 is being issued for absence of supervision.
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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.
SUPERVISORS NAME: Melinda Mohr
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4