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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407400
Report Date: 08/09/2019
Date Signed: 08/09/2019 12:34:39 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, THEFACILITY NUMBER:
073407400
ADMINISTRATOR:PAULO, JENAFACILITY TYPE:
830
ADDRESS:100 GATEKEEPER RDTELEPHONE:
(925) 560-9694
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY:53CENSUS: 0DATE:
08/09/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:TIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Paul Petersen and Licensing Program Manager (LPM) Wynn Norona, conducted an announced case management site inspection for this infant facility and met with facility director, Kelly Reinbolt, and applicant, Anju Khemani. This program is the infant program with a toddler component in a combination center which also houses a preschool. An application for a new school age program at this facility has also been submitted.

The facility has reported the following changes to the out door play areas for the infant and toddlers program; the renovation and addition of the side patio/play area and the alteration of dimensions of the toddler playground area. The infant and toddler play areas are fully fenced with no accessible bodies of water or hazardous conditions observed. The areas are distinctly separate to the preschool and school age outdoor play areas. There is shade and outdoor drinking water available. LPA measured both outdoor spaces resulting in the following measurements:

OUTDOORS: 4052.54 square feet = 54 children

The facility has a current license with a capacity of 53. The current outdoor play areas are sufficient for the licensed capacity. The side patio/play area and the toddler playground are approved for use by children in care effective 08/09/19.

An exit interview was conducted and a notice of site visit provided.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
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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