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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093610400
Report Date: 08/03/2022
Date Signed: 08/03/2022 11:47:53 AM


Document Has Been Signed on 08/03/2022 11:47 AM - 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:AL TAHOE SCHOOL HEAD STARTFACILITY NUMBER:
093610400
ADMINISTRATOR:GUTIERREZ, ROSAFACILITY TYPE:
850
ADDRESS:1100 LYONS AVE.TELEPHONE:
(530) 541-0284
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY:64CENSUS: 0DATE:
08/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jenny PettitTIME COMPLETED:
12:00 PM
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At 10:30 on Wednesday, August 3, 2022, Licensing Program Analysts (LPAs) Arianna Manabat and Mandie Goodwin and Licensing Program Manager (LPM) Natalie Dunaway met with Director, Jenny Pettit, for the purpose of an announced case management - licensee initiated inspection. Licensee requests a room change and a capacity change from 64 to 103 children. During today's visit there were no children in care. The facility's current hours of operation are Monday through Friday from 8:30 AM to 3:30 PM.

A health and safety inspection was conducted in all areas accessible to children. LPAs observed the facility had a sufficient amount of furniture, toys, and cubbies in the classrooms. LPAs advised that the tables and chairs should be suitable for preschool sized children . LPA observed disinfectants and medications are inaccessible and appropriately stored.

The total square footage for the classrooms is 3,608.53 square feet; C5=855sq, C6=891.75sq, C7=745.28sq, C8=1116.5sq which will accommodate 103 preschool children. (Measurements were used from the original pre-licensing inspections.)

LPAs observed the outdoor play area is fenced and equipped with a sufficient amount of play equipment and toys. The outdoor space was previously measured on August 2019 and includes 6,853 square feet which will accommodate 91 children. There is sufficient resilient material underneath climbing structures to absorb a fall.

Continued on LIC809-C......
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna ManabatTELEPHONE: (279) 200-2886
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)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: AL TAHOE SCHOOL HEAD START
FACILITY NUMBER: 093610400
VISIT DATE: 08/03/2022
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Prior to licensor the following must be completed;
1. A revised fire clearance must be received for 103 children
2. Waiver request for shared bathroom space
3. Waiver request for shared playground space

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.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna ManabatTELEPHONE: (279) 200-2886
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
LIC809 (FAS) - (06/04)
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