073407400-7-24-2019-52-CC-CACA-BC732Z-20190514175247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407400
Report Date: 05/14/2019
Date Signed: 07/24/2019 10:50:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GODDARD SCHOOL, THE		FACILITY NUMBER:	073407400
ADMINISTRATOR:	PAULO, JENA		FACILITY TYPE:	830
ADDRESS:	100 GATEKEEPER RD		TELEPHONE:	(925) 560-9694
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94582
CAPACITY:	53	CENSUS: 12	DATE:	05/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Alecia Sifuentes		TIME COMPLETED:	06:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced Annual/Random inspection. There were 7 staff and 25 children present during the inspection. This facility has a toddler option, of the 25 children present today 13 children were in the toddler option. The facility has age appropriate furniture and napping equipment which was observed to be in good condition. The indoor and outdoor activity space for the infant program is physically separate from the preschool component. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the visit. The sinks are in operable condition. The floors are free of tripping hazards. The kitchen/food preparation and storage area was observed to be clean. All storage containers for solid waste have tight-fitting covers that are in good repair. Outdoor activity space was observed to be safe and free of hazards. There is a shaded area provided for the children The facility is operating within its licensed capacity. The facility is within ratio today with one teacher supervising no more than 4 Infants. LPA did not observe any child left without visual supervision during the inspection. LPA verified both opening and closing staff have current CPR/First aid training. The director understands that prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review shall obtain a clearance or criminal record exemption. A sample of children’s records were reviewed. Files reviewed contained emergency information and health assessments. Staff records reviewed have required health screening. Teachers present today meet the qualification requirements.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 856-6376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GODDARD SCHOOL, THE	FACILITY NUMBER: 073407400
	VISIT DATE: 05/14/2019

NARRATIVE

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Fire/Disaster drill are conducted monthly.

The facility submitted a director package for Alecia Siruentes. To complete the director package, the following must be provided to CCL by 6/14/19:
- Verification of 4 years of experience.
- Proof of completion of 8 hour Preventative Health Practices.
- Proof of completion of Child Care Center Orientation : Operations and Record Keeping

This facility provides Incidental Medical Services-IMS. LPA reviewed the storage of medication and equipment and supplies, and reviewed children’s, personnel, and administrative records. LPA discussed the need to update the centers plan of operation to reflect IMS plan. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173. The following information regarding ADA was provided to licensee…US DOJ toll free ADA Information Line (800) 514-0301 and the link to FAQ about child care and ADA http://www.ada.gov/childqanda.htm

The director was encouraged to email ChildCareAdvocatesProgram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

Information on safe sleep was provided and discussed with Alecia Sifuentes.

There were no deficiencies cited during today’s inspection.

Exit interview conducted with Alecia Sifuentes.

Director was provided a copy of the appeal rights.

Notice of Site visit was provided at the time of inspection, and must be posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 856-6376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019

LIC809 (FAS) - (06/04)

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