<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846440
Report Date: 05/30/2024
Date Signed: 05/30/2024 02:44:34 PM

Document Has Been Signed on 05/30/2024 02:44 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
334846440
ADMINISTRATOR/
DIRECTOR:		KING,DIANNEFACILITY TYPE:
850
ADDRESS:18177 VAN BUREN BLVDTELEPHONE:
(951) 542-2900
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 144TOTAL ENROLLED CHILDREN: 50CENSUS: 33DATE:
05/30/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Assistant Director LaQuisha Nelson and Director Dianne KingTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 05/30/2024 at 8:00 AM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct a case management inspection in response to a self reported incident received on 05/17/2024. The LPA was greeted by the facility Assistant Director, LaQuisha Nelson. The LPA toured the facility and took a census of 33 children in care. The Director Dianne King joined the inspection at 9:55 AM. The Licensee Mohammad A. Zafar, arrived at approximately 10:30 AM and joined the inspection.

It was reported that on 05/09/2024, a daycare child in the preschool program allegedly hit another daycare child on the bottom, while in care. During the inspection, the LPA reviewed facility records, made observations and conducted interviews pertinent to the incident reported. The director was informed that further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

Exit interview conducted and report was reviewed with the licensee Mohammad A. Zafar, on behalf of the director.

A notice of site visit was issued and must remain posted for 30 days. The LPA observed the owner post the notice prior to exiting the facility.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1