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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073407398
Report Date: 08/06/2021
Date Signed: 08/06/2021 12:49:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2021 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210714134309
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
073407398
ADMINISTRATOR:INGRID ESCALANTEFACILITY TYPE:
850
ADDRESS:100 GATEKEEPER RDTELEPHONE:
(925) 560-9694
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY:108CENSUS: 0DATE:
08/06/2021
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Anju KhemaniTIME COMPLETED:
12:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights - Staff Handled Child Roungly
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/6/2021 at 11:40am Licensing Program Analyst (LPA) Morgan Pringle met with Owner Anju Khemani for the purpose of a Complaint filed against The Goddard School.

Based on interviews conducted it was alleged a staff member was handling a child in a rough manner. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days.
Appeal Rights were given and discussed. An exit interview was conducted.



Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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