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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624788
Report Date: 06/16/2023
Date Signed: 06/16/2023 10:29:20 AM

Document Has Been Signed on 06/16/2023 10:29 AM - 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:
343624788
ADMINISTRATOR:PU, WILLIAMFACILITY TYPE:
850
ADDRESS:3370 ZINFANDEL DRIVETELEPHONE:
(916) 861-0906
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 101DATE:
06/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Katelynn LeeTIME COMPLETED:
10:45 AM
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Licensing Program Manager (LPM) Natalie Dunaway, and Licensing Program Analyst (LPA), Erwina Pascual-Golamco, met with Director, Katelynn Lee, for a case management visit to discuss concerns. LPA and LPM discussed complaint and appeal procedures.

Census included 101 preschool children and 17 staff. The meeting was with Directors Katelynn Lee, Kimberly Nelson Ingle, Selena Rovane and owner Bill Pu.

There are no deficiencies cited during today's visit.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2023
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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