313621361-8-4-2021-03-CC-KPES-C5ZL7X-20210818083105

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313621361
Report Date: 08/04/2021
Date Signed: 08/04/2021 10:32:23 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/21/2021 and conducted by Evaluator Jeremey McClain

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210621112932

FACILITY NAME:	GODDARD SCHOOL, THE (PS)		FACILITY NUMBER:	313621361
ADMINISTRATOR:	APRIL WARREN		FACILITY TYPE:	850
ADDRESS:	2021 WILDCAT BLVD		TELEPHONE:	(916) 778-6620
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	132	CENSUS: 92	DATE:	08/04/2021
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Ashish and Sharmili Naik		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility is operating over ratio
Unqualified staff providing care and supervision to children

INVESTIGATION FINDINGS:

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On August 4th, 2021 Licensing Program Analyst (LPA) Jeremey McClain met with Licensees Ashish and Sharmilli Naik for the purpose of closing a complaint investigation. At approximately 8:5e 5am, LPA observed the following ratios: seven children supervised by two staff members, eight children supervised by three staff, six children supervised by two staff, 12 children supervised by two staff members, 21 children supervised by two staff members, 20 children supervised by three staff members, and 18 children supervised by two staff members. It was alleged that the facility was operating over ratio and also had unqualified staff supervising in the infant room. During the investigation, LPA conducted interviews with staff and parents, made observations at the facility, and reviewed staff files. The evidence gathered was not sufficient to dismiss or corroborate the allegations. The preponderance of evidence standard has not been met, therefore, the allegations are determined to be unsubstantiated.

There were no Title 22 deficiencies related to these allegations. LPA reviewed this report with the Licensees and provided a Notice of Site Visit that must be posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/21/2021 and conducted by Evaluator Jeremey McClain

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210621112932

FACILITY NAME:	GODDARD SCHOOL, THE (PS)		FACILITY NUMBER:	313621361
ADMINISTRATOR:	APRIL WARREN		FACILITY TYPE:	850
ADDRESS:	2021 WILDCAT BLVD		TELEPHONE:	(916) 778-6620
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	132	CENSUS: 92	DATE:	08/04/2021
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Ashish and Sharmili Naik		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is operating without a Director
Licensee is not following reporting requirements

INVESTIGATION FINDINGS:

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On August 4th, 2021 Licensing Program Analyst (LPA) Jeremey McClain met with Licensees Ashish and Sharmili Naik for the purpose of closing a complaint investigation. At approximately 8:50 am, LPA observed four infants supervised by one teacher. It was alleged that the facility operated without a director and did not report a director change to licensing. It was also alleged that the facility did not follow the department’s reporting requirements by failing to report an unusual incident that involved an injury to a child. During the investigation, LPA conducted interviews with staff and parents, made observations at the facility, and reviewed staff files. The evidence gathered was sufficient to confirm the allegations. The preponderance of evidence standard has been met, therefore, the allegations are determined to be substantiated.

Title 22 deficiencies are cited on the subsequent page of this report. If not corrected, the deficiency is considered a potential risk to the health and safety of children in care. Appeal Rights were provided, and an exit interview was conducted. A Notice of Site Visit was posted and must remain posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20210621112932

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GODDARD SCHOOL, THE (PS)	FACILITY NUMBER: 313621361
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/04/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/04/2021 Section Cited CCR 101212(b)	1 2 3 4 5 6 7	The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement was not met as evidenced through interviews with Licensee’s Ashish and Sharmili Naik.	1 2 3 4 5 6 7	The licensees are aware that director changes must be reported to the department within 10 days of the change. Licensees have submitted director qualifications to the department for the current director. The licensee will also become director qualified and submit the qualifications to the department,
	8 9 10 11 12 13 14	A director change occurred on April 16th, 2021 and it was not reported to licensing. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14	in order to serve as an immediate back up in the case of a change of directorship.
Type B 08/04/2021 Section Cited CCR 101212(d)(1)(B)	1 2 3 4 5 6 7	Reporting Requirements. (d)Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in	1 2 3 4 5 6 7	Licensees are aware of the reporting requirements regarding unsual incidents. Licensees have developed a plan to notify the department of an unusual incident with 24 hours of the incident, and submitt an unsual incident form (LIC 624) within a week.
	8 9 10 11 12 13 14	(d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.(1)Events reported shall include the following: (B)Any injury to any child that requires medical treatment. This requirement was not as evidenced through interviews with Licensee’s Ashish and Sharmili Naik. It was stated that Child #1 was injured while in care on April 21st. Child #1 suffered a sprain to a bone in their arm, which required medical attention. This incident was not reported to the Department as required. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

LIC9099 (FAS) - (06/04)

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