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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701000
Report Date: 10/12/2021
Date Signed: 10/12/2021 01:18:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
376701000
ADMINISTRATOR:FERNANDO TORRESFACILITY TYPE:
830
ADDRESS:4625 RED BLUFF PLACETELEPHONE:
(760) 730-9450
CITY:CARLSBADSTATE: CAZIP CODE:
92010
CAPACITY:28CENSUS: 19DATE:
10/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Director Fernando Torres and Licensee Shalini DhimanTIME COMPLETED:
01:25 PM
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On 10/12/21 at 11:30 a.m., Licensing Program Analyst, Joelle Redding, met with Director Fernando Torres and Licensee Shalini Dhamin, for the purpose of an unannounced annual inspection. There were 19 infants total. A teacher and two Aides with 11 older infants in Room #2 and two teachers and 8 younger infants in Room #1. Facility is within ratio and capacity.

LPA toured the facility. The rooms were clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. All required forms were posted. The furniture, books, games and toys are safe, age-appropriate and in good repair. There is a variety of activities provided throughout the day. Infant foods/beverages are labeled/dated and stored per regulation in the infant room refrigerator. Food service area for older infants eating solid food consists of a kitchen which is clean and sanitary. Food is stored in covered containers at 45 degrees or less and there is no expired or contaminated food present. Staff preparing food are using proper personal hygiene and food service practices. The food meets the nutritional requirements per regulation and is of good quality and proper quantity. The children bring their own lunches and the facility provides a.m. and p.m. snack. Snack menu is posted, changes are recorded, and menus are stored for 30 days. Food has been stored separately from any chemicals or cleaning products and food preparation sink is separate from diaper/changing and toilet/potty chair handwashing sink.

Infant bedding/napping equipment is in good repair with standard cribs and mattresses of a water-resistant material, disinfected daily. Cribs are spaced adequately apart to meet regulation and are not blocking an entrance or an exit. Tight fitting crib sheets are in place, bedding is stored separately, and each child has his/her own. No children are using the same crib. Soiled sheets are kept inaccessible to children and bedding is washed/changed daily or more often, if necessary. Infant changing tables have padded, washable vinyl at least one inch thick with sides raised at least 3 inches, per regulation and are within arm’s reach of a

SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 376701000
VISIT DATE: 10/12/2021
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sink that is not used for food preparation. The sink and changing table are disinfected between each use. Hand washing and toileting areas are in a safe, sanitary and operating condition. There is at least one potty chair or toilet with training seat present for every 5 infants who are potty training. Potty chairs are not accessible to children without supervision and are emptied and disinfected after each use. All storage containers or trash cans containing solid or diaper waste have tight fitting lids and are in good repair. Any wastewater used to clean is being discarded after use.

Each infant is to be under direct visual observation and supervision by staff at all times. The napping area does have a half or transparent wall that allows for audio and visual supervision from the activity area. Sleep checks are conducted and documented every 15 minutes for all infants. Appropriate supervision was in place during this visit.

The outdoor activity space is fully fenced and separate from other programs with age-appropriate play equipment., securely anchored to the ground. There is sufficient cushioning and adequate shade. Drinking water is available at all times, both inside and outside. There are several staff present with current CPR and First Aid certification. Medications are stored in each classroom, clearly marked, inaccessible to children with all required documentation in place. There is no evidence of rodent or insect activity. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children. LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. All were found to be in compliance with Title 22 regulation. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com. Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is Ms. Dhamin's office.

The facility has sufficient Personal Protective Equipment (PPE) and understand that current County requirements state that all staff regardless of vaccination, are to wear masks while indoors. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident.

SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 376701000
VISIT DATE: 10/12/2021
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LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm . Services are not in place today.



Licensee and Director were reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Licensee is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process. LPA conducted child care quality management interview with Director Fernando Torres and Licensee Shalini Dhiman. Exit interview conducted and report was reviewed with the both as well. See LIC 809D for deficiency. NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 376701000
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in that none of the 8 infants under 12 months present today had an LIC 9227 on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2021
Plan of Correction
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Director Fernando Torres states that the LIC 9227 will be completed and on file for all children under the age of 12 months by the plan of correction date of 10/26/21.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4