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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343620245
Report Date: 04/05/2024
Date Signed: 04/05/2024 11:39:25 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/16/2024 and conducted by Evaluator Jennifer Velasco
COMPLAINT CONTROL NUMBER: 03-CC-20240216121318
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
343620245
ADMINISTRATOR:KATHRYN DRAKEFACILITY TYPE:
850
ADDRESS:251 OUTCROPPING WAYTELEPHONE:
(916) 936-0377
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:132CENSUS: 84DATE:
04/05/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kaylee AgamanTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
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9
Staff handled a child roughly.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Jennifer Velasco met with Facility Representative, owner Kaylee Agaman (Owner), for the purpose of conducting an unannounced subsequent complaint investigation inspection pertaining to the above allegation. The incident related to the allegation was self-reported by the facility in a timely manner. The purpose of today's inspection was explained to Owner. During today's inspection, LPA conducted interviews with staff and children, observed care, and obtained and reviewed relevant documentation. Witness statements, LPA observations, and/or document reviews failed to corroborate the allegation. Witness statements provided evidence a child scratched a teacher but did not provide evidence that the teacher scratched or grabbed the child. Although the allegation may have happened, there is not a preponderance of evidence to prove the allegation; therefore, the allegation is unsubstantiated. Exit interview was conducted and report was reviewed with Facility Representative, Kaylee Agaman. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.



Exit interview was conducted and a copy of this report was given to the Facility Representative Kaylee Agaman. Notice of site was given and must remain posted for parental review for 30 days. Appeal rights were provided
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024
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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