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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343620245
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:20:44 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 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
10/12/2022 and conducted by Evaluator Jennifer Velasco
COMPLAINT CONTROL NUMBER: 03-CC-20221012150254
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
343620245
ADMINISTRATOR:FERGUSON, JAMIEFACILITY TYPE:
850
ADDRESS:251 OUTCROPPING WAYTELEPHONE:
(916) 936-0377
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:132CENSUS: 111DATE:
01/12/2023
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Heather HatfieldTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Facility is not abiding by the terms and conditions of the admission agreement
INVESTIGATION FINDINGS:
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Licensing Program Analyst Jennifer Velasco (LPA) conducted a follow up complaint investigation inspection and met with Facility Represenattive Heather Hatfield (D1). LPA investigated an allegation the facility was not abiding by the terms and conditions of the admission agreement. During the investigation, LPA engaged in observation, conducted interviews, and obtained and reviewed facility records. Information obtained during observations, interviews, and document reviews corroborated the allegation that the facility did not abide by the terms of the admission agrement. The preponderance of evidence standard has been met; therefore, the allegation is substantiated. LPA observed 111 preschool and toddler children in care with nine classroom staff.
California Code of Regulations (CCR) citation is documented on the attached LIC 9099D. This report and appeal rights were provided and reviewed with the facility representative. Notice of Site Visit shall remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: 707-953-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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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Control Number 03-CC-20221012150254
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 343620245
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/03/2023
Section Cited
CCR
101219(f)
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The licensee shall comply with all terms and conditions set forth in the admission agreement. This requirement was not met as evidenced by: LPA review of facility's admission agreement, which specifies the hours as 7:00 AM - 6:00 PM, and review of signage and email to parents stating
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Facility representative (D1) stated the facility has now updated the admission agreement to advise parents if there is a staffing or other shortage, the facility's hours may be reduced. D1 stated she will email the updated admission agreement to LPA at
jennifer.velasco@dss.ca.gov
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in October 2022, facility hours would be reduced to 7:30 AM - 5:30 PM. The admission agreement does not stipulate the possibility of possible reduction of hours. This constitutes a potential risk to children in care.
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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: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: 707-953-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC9099 (FAS) - (06/04)
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