075700605-4-29-2021-52-CC-JJAG-C2QQZS-20210505123710

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 075700605
Report Date: 04/29/2021
Date Signed: 04/29/2021 11:54:13 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/09/2021 and conducted by Evaluator Jabari Wilson

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20210309084847

FACILITY NAME:	GODDARD SCHOOL, THE		FACILITY NUMBER:	075700605
ADMINISTRATOR:	INGRID ESCALANTE		FACILITY TYPE:	840
ADDRESS:	100 GATEKEEPER ROAD		TELEPHONE:	(925) 577-6001
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94582
CAPACITY:	30	CENSUS: 56	DATE:	04/29/2021
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Ingrid Escalante & Anju Khemani		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Facility staff used an excessive form of punishment.

INVESTIGATION FINDINGS:

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On 04/29/2021 Licensing Program Analysts (LPA) Jabari Wilson and Jaylena Miller conducted an unannounced subsequent complaint investigation at the facility. LPAs met with Director Ingrid Escalante and Owner Anju Khemani and explained the purpose of today’s inspection. The finding for the above allegation was delivered during the visit.

During the investigation the department completed a physical plant inspection, reviewed facility records, and conducted interviews. LPAs interviews with staff and children determined there was not enough evidence to support that staff used excessive form of punishment. LPAs conducted an interview with RP who indicated his child was very upset and crying, his opinion was that he was “punished for nothing." Based on the interviews and information obtained throughout the investigation, the allegation is unsubstantiated. 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 deemed UNSUBSTANTIATED.

The director was provided a copy of this report and appeal rights, and the signature on this form acknowledges receipts of these rights. An exit interview was conducted with director and Notice of Site visit was provided and posted on the wall.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Jabari Wilson	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021

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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