034500788-5-12-2026-53-CC-KGUA-DUGQG6-20260527120902

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 034500788
Report Date: 05/12/2026
Date Signed: 05/12/2026 02:48:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/04/2026 and conducted by Evaluator Jennie Tedlos

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20260304160729

FACILITY NAME:	MOTHER LODE MOUNTAIN TOTS PRESCHOOL		FACILITY NUMBER:	034500788
ADMINISTRATOR:	ALLEN, KIRBIE		FACILITY TYPE:	860
ADDRESS:	23714 STATE HIGHWAY 88		TELEPHONE:	(209) 295-1230
CITY:	PIONEER	STATE: CA	ZIP CODE:	95666
CAPACITY:	48	CENSUS: 25	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Kirbie Allen		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Lack of staff supervision resulted in daycare children being bitten by another daycare child.
Staff did not properly notify daycare child's responsible party of incidents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jennie Tedlos met with Director, Kirbie Allen (D1), to deliver findings of the complaint investigation regarding the above (2) allegations submitted to Licensing. There were 22 Preschool, 3 Infant, and 0 School Age children at the time of LPA's arrival. There were 2 staff supervising the Preschool classroom.

It was alleged that a lack of supervision resulted daycare children obtaining injuries. There was a concern that a child (C1) wasn't being supervised properly, resulting in C1 causing injury to children in care. During the course of the investigation, LPA Tedlos obtained documents, conducted classroom observations, and conducted interviews with staff, children, and parents of children who attend the facility. During classroom observatios, LPA observed proper ratio and supervision techniques. Interviews with staff reveal that children who need extra guidance are often shadowed by teachers to teach communication skills between children in care. Conflicts between children result in staff intervention, helping children to communicate, and often times redirection. Children state through interviews that teachers are nearby and supervising children at a close distance. Report continues on 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 53-CC-20260304160729

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MOTHER LODE MOUNTAIN TOTS PRESCHOOL	FACILITY NUMBER: 034500788
	VISIT DATE: 05/12/2026

NARRATIVE

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It was alleged that staff did not notify day care child's responsible party of incidents. There was a concern that the facility did not contact C1's authorized representatives of incidents caused by C1. LPA learned through record review and staff interviews that parents of children who obtain serious injuries are called immediately. When children obtain less serious injuries, a report is sent via Brightwheel to the injured child's authorized representative or a written report is provided during pick up. Parents interviewed did not have concerns regarding reporting of incidents and state that any injuries are communicated to them right away or during pick up.

Interviews with staff, children, and parents of children at the facility did not support the allegations.

Based on the information obtained throughout the course of this investigation for the above allegations, LPA Tedlos determined that the allegations were found to be UNSUBSTANTIATED, meaning although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit Interview was conducted with the Director, Kirbie Allen.

A notice of site visit was provided and must remain posted for 30 days

***This is an amended version of an original report dated 05/12/26.***

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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