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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408899
Report Date: 11/16/2021
Date Signed: 11/16/2021 05:12:09 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/25/2021 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20210825143444

FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
073408899
ADMINISTRATOR:KATHERINE ESPANOL RIVASFACILITY TYPE:
830
ADDRESS:115 TECHNOLOGY WAYTELEPHONE:
(925) 390-3313
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:24CENSUS: 5DATE:
11/16/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Katherine Rivas and Geetha VenkataganeshTIME COMPLETED:
05:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility accepting children with symptoms of COVID-19.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licesning Program Analyst (LPA) Cherie Acosta conducted an unannounced visit to investigate the above allegation.
During the investigation LPA conducted interviews and reviewed documnets. LPA is unable to determine if the facility has accepted children with symptoms of COVID-19.

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 deemed unsubstantiated.

Exit interview conducted with Katherine Rivas
Notice of Site Visit was provided and must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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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