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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343620245
Report Date: 12/23/2024
Date Signed: 01/07/2025 05:34:01 PM

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
12/21/2024 and conducted by Evaluator Dao Vang
COMPLAINT CONTROL NUMBER: 03-CC-20241221200115
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: 34DATE:
12/23/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Kaylee AgamanTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff do not ensure that facility is free of pests.
INVESTIGATION FINDINGS:
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On December 23th, 2024 at 12:00p.m., Licensing Program Analyst (LPA) Pa Dao Vang met with Licensee Representative Kaylee Agaman, to conduct an unannounced inspection on a Complaint Report submitted to the regional office on 12/21/2024. LPA observed 34 children supervised by 5 staff during nap time.

During today’s inspection, LPA conducted interviews, made observations, and took images of the facility regarding the above allegations. Director shows proof of pest control coming to the facility several times to set out glue traps around the facility. The box of dry food that was contaminated was throw out immediately. Director have also put all the storage food in large plastic containers. Director also checks on the glue traps every day and have not noticed any pest activity.

Based on LPA’s interviews and observations, there are no California Code of Regulations, Title 22 violations at the facility.
Continue on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 03-CC-20241221200115
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 343620245
VISIT DATE: 12/23/2024
NARRATIVE
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Therefore, although the alleged violations may have happened or are valid, the preponderance of evidence standard has not been met to fully prove or disprove that they did or did not occur, therefore the allegation of staff do not ensure that facility is free of pests is unsubstantiated. An exit interview was conducted with the Licensee Representative Kaylee Agaman . Appeal rights and a notice of site visit were provided. Notice of site visit shall remain posted for a period of 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2