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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370239
Report Date: 03/24/2021
Date Signed: 03/24/2021 03:13:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
304370239
ADMINISTRATOR:BISHOP, TIMOTHYFACILITY TYPE:
850
ADDRESS:1 AURA LANETELEPHONE:
(949) 218-6200
CITY:LADERA RANCHSTATE: CAZIP CODE:
92694
CAPACITY:158CENSUS: 138DATE:
03/24/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Executive Director, Ana SalinasTIME COMPLETED:
10:00 AM
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Tele- Inspection Case Management Visit due to COVID-19 State of Emergency

Licensing Program Analyst (LPA) Cindy Nguyen conducted a case management inspection in response to a self reported incident. LPA Nguyen notified the administrative that due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing a Tele-Inspection would be conducted.

A FaceTime call was made with Executive Director, Ana Salinas. During the Tele-Inspection there were 8 toddlers belong to toddler option program with 2 staff in one room, 130 preschool age children, and 14 preschool staff. During today's tele-inspection it was determined that the facility was operating within the licensed capacity and within compliance of staffing ratios. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.



During today's inspection, LPA interviewed 2 staff members, and conducted tele-inspection. Due to insufficient information available at this time, further interviews and record reviews are required.

An exit interview was conducted with the Executive Director, Ana Salinas, via tele-inspection on this date. Appeal Rights were reviewed and explained. A copy of this report and Appeal Rights (LIC 9058 1/16) where emailed to the administrative. First level appeals should be sent to the Regional Manager to the address listed above. The administrative will email a received acknowledgement as her signature for this report due to the tele-inspection delivery by typing, “I have read and received the Evaluation Report, I acknowledge receipt” in the subject line of the return email.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021
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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