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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407398
Report Date: 01/10/2024
Date Signed: 01/10/2024 03:40:13 PM

Document Has Been Signed on 01/10/2024 03:40 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
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: 108TOTAL ENROLLED CHILDREN: 61CENSUS: 57DATE:
01/10/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Ingrid EscalanteTIME COMPLETED:
03:39 PM
NARRATIVE
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On 1/10/2024 at 1:00pm Licensing Program Analyst (LPA) Morgan Pringle met with Director Ingrid Escalante for an Unannounced Required 3-Year Inspection. There were eight (57) preschool age children, and ten (10) additional staff present during the inspection. Seven classrooms (Sparrows, Parrots, Peacocks, Falcons, Eagles, Owls, and Robins) were toured for a health and safety inspection. The facility operates from 7:30am – 5:30pm, Monday – Friday. The facility also holds a license for infants, Facility #073407400 and school age, Facility #75700605 as well.

The facility has ample age-appropriate materials in the classrooms that were observed to be clean and in good condition. All toxins, cleaning products, children’s medication, and hazardous materials were observed to be in inaccessible areas. All children’s bathrooms were observed to be clean, well maintained, free of defects with an ample number of sinks and toilets that are in proper working order. All diapering materials were observed to be clean and well maintained and properly stored. The facility uses child sized mats for sleeping and all children bring their own napping materials. All equipment used for napping was observed to be clean, free from defects and properly stored. There are multiple fully charged fire extinguishers, carbon monoxide detectors, smoke detectors and first aid kits on site. The facility does not transport children.

The kitchen was observed to be clean, well maintained, free from defects and hazards and made inaccessible to the children in care. All food on site is properly labeled and stored. The facility provides two (2) snacks per day and all children provide their own lunch. All food that is brought from the children’s home is properly labeled and stored. All children bring their own water bottles to school and have access to clean drinking water on site as well.


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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
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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Document Has Been Signed on 01/10/2024 03:40 PM - It Cannot Be Edited


Created By: Morgan Pringle On 01/10/2024 at 03:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 073407398

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/11/2024
Plan of Correction
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Three (3) children present were not signed in. Director will make sure to obtain the signature from the child's authorized representative and send LPA Pringle a copy of the sign in/out sheet by end of business day Thursday 1/11/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Morgan Pringle
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2024


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 073407398
VISIT DATE: 01/10/2024
NARRATIVE
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The outside play yard is fully fenced with ample age-appropriate materials for the children. The play structure was observed to be well maintained with ample cushion under the slide for children’s safety. There is ample shade for the children as well. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The facility is operating within its licensed capacity and is in ratio. All staff working have obtained a criminal record clearance, exemption, or transfer. The fire/disaster drill log is complete with the last drill logged on 12/14/2023. A physical census of the children was taken and cross referenced with the sign-in and out log. Through record review three (3) children were not signed in (see LIC809D). All required postings, including the menu are posted in the entrance of the facility. LPA obtained a sample of the children’s files, the staff files, and the facility files. All files were complete.

Deficiencies Cited During LPA's Inspection
  • Three (3) children were not signed in by their parent or authorized representative

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Personnel and facility roster must be properly maintained, and fire/disaster drills must be conducted at least every six (6) months and documented. Licensee was reminded that California law requires facilities to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, facilities must submit the Unusual Incident/Injury form (LIC 624) to the Department. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 073407398
VISIT DATE: 01/10/2024
NARRATIVE
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Ingrid Escalante.




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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC809 (FAS) - (06/04)
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