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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 093623907
Report Date: 05/25/2022
Date Signed: 05/27/2022 09:01:38 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2022 and conducted by Evaluator Michelle Pascual
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220506105125
FACILITY NAME:LAKE TAHOE PRESCHOOLFACILITY NUMBER:
093623907
ADMINISTRATOR:VAZQUEZ-ALAMILLO, LISETFACILITY TYPE:
850
ADDRESS:2111 SOUTH AVENUETELEPHONE:
(530) 416-2324
CITY:LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY:49CENSUS: 39DATE:
05/25/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Stefanie ToutolminTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Other- Facility license number is incorrect on website
INVESTIGATION FINDINGS:
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At approximately 01:00PM, on May 25th, 2022, Licensing Program Analyst (LPA) Michelle Pascual met with Licensee, Stefanie Toutolmin to close a complaint investigation.
Today’s census was 39 children supervised by 4 staff. It was alleged that the facility had advertised the facility number wrong on their website from April 6th, 2022 to May 6th, 2022.
Throughout the investigation, LPA Arianna Manabat conducted interviews with Reporting Party and Licensee. Based on interviews, observations, and record review, LPA Manabat observed that the facility’s number was initially listed on the website as 093620301 on April 6th 2022, then as 093623901 on April 7th, 2022, and finally as 093620307 on May 6th, 2022. Based on LPA observations and record reviews, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.
Type B violation
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022
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 3
Control Number 03-CC-20220506105125
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LAKE TAHOE PRESCHOOL
FACILITY NUMBER: 093623907
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2022
Section Cited
CCR
101162(1)
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Licensees shall reveal each child care center license number in all advertisements in accordance with Health and Safety Code Section 1596.861.
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Facility has already changed the license number to reflect the current license number
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This requirement was not met by the license number having an incorrect number on the website when adversting
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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: Roxana Saravia
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20220506105125
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LAKE TAHOE PRESCHOOL
FACILITY NUMBER: 093623907
VISIT DATE: 05/25/2022
NARRATIVE
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Based on LPA observations and record reviews, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.
Type B violation.

An exit interview was conducted and a notice of site visit was given to be posted for 30 days
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3