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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621361
Report Date: 01/09/2025
Date Signed: 01/09/2025 12:10:45 PM

Document Has Been Signed on 01/09/2025 12:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 (PS)FACILITY NUMBER:
313621361
ADMINISTRATOR/
DIRECTOR:		SHARMILI NAIKFACILITY TYPE:
850
ADDRESS:2021 WILDCAT BLVDTELEPHONE:
(916) 778-6620
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 110DATE:
01/09/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Tayler FranklinTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Tayler Franklin for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPAs observed 110 children supervised by 16 staff members.

It was reported that on 01/06/2025, a child (C1) tripped on the playground and suffered a cut on their chin, which required stitches. C1 was immediately attended to by staff and their parents were contacted. During today’s inspection LPA reviewed the incident report that was given to C1’s parents, conducted interviews with the staff that observed the incident, and observed the area where the injury occurred. Incident reports were consistent, and LPA did not observe the area to be hazardous.

An exit interview was conducted, and the report was reviewed with facility representative Tayler Franklin. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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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