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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 093620107
Report Date: 04/22/2026
Date Signed: 04/22/2026 03:07:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO 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
02/12/2026 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20260212114717
FACILITY NAME:LTUSD PRESCHOOL PROGRAMFACILITY NUMBER:
093620107
ADMINISTRATOR:LINDSTROM, AMYFACILITY TYPE:
850
ADDRESS:1100 LYONS AVENUETELEPHONE:
(530) 541-2850
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY:20CENSUS: 8DATE:
04/22/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Amy LindstromTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Unqualified staff are providing care and supervision to day care children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Gagandeep Singh and Sala Vang met with facility representative, Amy lindstrom, to deliver the findings for the above allegation.

During the complaint intake process, it was alleged that the present staff does not have required trainings including Pediatric CPR training. During the investigation, LPAs observed the present facility staff has BLS (Basic Life Support) training certificate on file. LPAs reminded the facility representatives that at least one staff member must have Pediatric CPR training from EMSA approved vendor. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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-20260212114717
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LTUSD PRESCHOOL PROGRAM
FACILITY NUMBER: 093620107
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/22/2026
Section Cited
CCR
101216(f)
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At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
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The facility will have at least one staff member on site with Pediatric CPR training.
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This requirement is not met as evidenced by record review, it was found that present staff only has Basic Life Support training, not pediatric CPR training. This poses a potential Health and Safety risk to children in care.
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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: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO 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
02/12/2026 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20260212114717

FACILITY NAME:LTUSD PRESCHOOL PROGRAMFACILITY NUMBER:
093620107
ADMINISTRATOR:LINDSTROM, AMYFACILITY TYPE:
850
ADDRESS:1100 LYONS AVENUETELEPHONE:
(530) 541-2850
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY:20CENSUS: 8DATE:
04/22/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Amy LindstromTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff made inappropriate comments toward a child.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Gagandeep Singh and Sala Vang met with facility representative, Amy lindstrom, to deliver the findings for the above allegation.

During the complaint intake process, it was alleged that a staff member made an inappropriate comment. During the investigation, LPAs inspected the facility and conducted interviews. During the interviews, it was found a substitute staff member made a compliment. However, it not found that the comment was harmful or negative toward the child. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3