343615181-11-5-2021-03-CC-MMAA-C8ZTPX-20211122135500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343615181
Report Date: 11/03/2021
Date Signed: 11/05/2021 03:13:16 PM

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
09/08/2021 and conducted by Evaluator Michelle Pascual

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210908090655

FACILITY NAME:	GODDARD SCHOOL, THE		FACILITY NUMBER:	343615181
ADMINISTRATOR:	LEE, KATELYNN		FACILITY TYPE:	850
ADDRESS:	10710 BEAR HOLLOW DRIVE		TELEPHONE:	(916) 861-0906
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY:	108	CENSUS: 76	DATE:	11/03/2021
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Katelynn Lee		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Ratio- Facility is operating over ratio
License- Facility staff are co-mingling children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pascual met with Director Katelynn Lee and owner Bill Pu on November 3rd, 2021 approximately at 12:50PM to deliver complaint findings for the allegations mentioned above.

It was alleged that “facility is operating over ratio” and “facility staff are co-mingling children.” During the course of the investigation LPA conducted interviews with the reporting party, staff, Program Director and owner. LPA also conducted observations while touring the facility on 09/15/2021 unannounced and obtained documents relevant to the complaint allegation. Based on the information obtained, LPA was not able to corroborate the facility operating out of ratio and the co-mingling of children. The allegation is determined to be UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it.

Notice of site visit shall remain posted for 30 days for parental review.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021

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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