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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343615197
Report Date: 11/03/2021
Date Signed: 11/05/2021 03:17:40 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-20210908091742
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
343615197
ADMINISTRATOR:LEE, KATELYNNFACILITY TYPE:
830
ADDRESS:10710 BEAR HOLLOW DRIVETELEPHONE:
(916) 861-0906
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:24CENSUS: 15DATE:
11/03/2021
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Katelynn LeeTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
License- Facility operating out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Pascual met with Director Katelynn Lee and owner Bill Pu on 11/3/2021 approximately at 12:50PM to deliver complaint findings for the allegation mentioned above.

It was alleged that “facility is operating over ratio." 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, unannounced on 9/15/2021 and obtained documents relevant to the complaint allegation.

Based on the information obtained, LPA was not able to witness the facility operating out of ratio during any observations and tours of the facility. Moreover documents obtained do not corroborate the allegation. Therefore 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 SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (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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