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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621361
Report Date: 11/05/2021
Date Signed: 11/05/2021 12:59:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
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
ADMINISTRATOR:HANNAH SIMMONSFACILITY TYPE:
850
ADDRESS:2021 WILDCAT BLVDTELEPHONE:
(916) 778-6620
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:132CENSUS: 89DATE:
11/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Millie NaikTIME COMPLETED:
01:00 PM
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On November 5th, 2021 at 9:00 am, Licensing Program Analysts (LPAs) Jeremey McClain and Josiah Gathing met with licensee Millie Naik, for the purpose of an unannounced annual random inspection. Facility hours of operation are Monday through Friday from 7:00 AM to 6:00 PM.

LPA observed a census of 89 preschool children, supervised by 14 teachers in seven different classrooms.

LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are appropriately stored and inaccessible to children. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with bark to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. Program provides snacks, and families provide their own meals for children. Menus were posted and drinking water was readily available to children both indoors and outdoors. The facility currently utilizes and electronic sign in and out sheet.

Staff and children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification which expires 7/2023. All staff currently employed with the facility have: a criminal record clearance, a health screening report, AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience. LPA observed functional smoke and carbon monoxide detectors.

Incidental Medical Services (IMS) policy was discussed. The facility is currently providing IMS and has a plan of operation was provided by physicians. LPA discussed the necessity or the facility to develop a plan as well. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.


Report continued on the following page.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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
VISIT DATE: 11/05/2021
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When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA reminded the Director that the Mandated Reporter Training must be completed by all staff once every two years, and that the training can be found at: http://childcare.mandatedreporterca.com/



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were observed during today’s inspection.



This report was reviewed with licensee, and an exit interview was conducted.

A Notice of Site Visit was provided and should remain posted for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
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