313621362-11-5-2021-03-CC-JMCN-C8GRGW-20211105130125

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313621362
Report Date: 11/05/2021
Date Signed: 11/05/2021 01:01:35 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 (INF)		FACILITY NUMBER:	313621362
ADMINISTRATOR:	HANNAH SIMMONS		FACILITY TYPE:	830
ADDRESS:	2021 WILDCAT BLVD		TELEPHONE:	(916) 778-6620
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	24	CENSUS: 12	DATE:	11/05/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Millie Naik		TIME COMPLETED:	01:00 PM

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On November 5^th, 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.

LPAs observed a census of 12 infants, supervised by four teachers in two separate classrooms.

LPAs toured the building including all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are stored in an area that is inaccessible to children in care. 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. Infant changing tables have a padded surface that is washable and at least one-inch-thick, and the changing tables have raised sides that are at least three inches high. 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 snack and families provide lunches for their children. Menus were posted and drinking water was readily available to children both indoors and outdoors. Facility utilizes and electronic system parent signatures.

Staff and children's records were reviewed. Each child's file contained an emergency card, a medical assessment, and Infant Needs and Services Plan. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 7/2023). All staff currently employed with the facility have a criminal record clearance, health screening report, Mandated Reporter training certificates, and documentation of the educational background, training, and/or experience. There are no firearms or bodies of water on the premises. LPA observed functional smoke and carbon monoxide detectors.

Report continued on the following page

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (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)

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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 (INF)	FACILITY NUMBER: 313621362
	VISIT DATE: 11/05/2021

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

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 Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (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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