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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620245
Report Date: 01/07/2025
Date Signed: 01/07/2025 05:36:11 PM

Document Has Been Signed on 01/07/2025 05:36 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, THEFACILITY NUMBER:
343620245
ADMINISTRATOR/
DIRECTOR:		KATHRYN DRAKEFACILITY TYPE:
850
ADDRESS:251 OUTCROPPING WAYTELEPHONE:
(916) 936-0377
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 76DATE:
01/07/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:45 PM
MET WITH:Kaylee AgamanTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
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On January 7, 2025, Licensing Program Analyst (LPAs) Pa Dao Vang and Amanda Sutter met with Licensee Representative Kaylee Agaman for a case management inspection to amend the reports. LPAs observed 76 children supervised by 13 staff.

No deficiencies were cited today. An exit interview was conducted, a copy of this report, and notice of site visit were provided to Licensee Representative Kaylee Agaman.
Seychelle De LucaTELEPHONE: (916) 263-5719
Dao VangTELEPHONE: (916) 216-7798
DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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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