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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075700605
Report Date: 10/07/2024
Date Signed: 10/07/2024 12:47:31 PM

Document Has Been Signed on 10/07/2024 12:47 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:
075700605
ADMINISTRATOR/
DIRECTOR:
INGRID ESCALANTEFACILITY TYPE:
840
ADDRESS:100 GATEKEEPER ROADTELEPHONE:
(925) 577-6001
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 30TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/07/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:29 AM
MET WITH:Ingrid EscalanteTIME VISIT/
INSPECTION COMPLETED:
12:44 PM
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On 10/7/2024 at 9:29am Licensing Program Analyst (LPA) Morgan Pringle met with Director Ingrid Escalante for an Unannounced Annual/Random Inspection. There were no children and one (1) additional staff member present upon LPAs arrival. Nine (9) school age children arrived around 10:40am from the neighboring Elementary school Quail Run. The facility has an infant and preschool program on site as well. One (1) classroom, The Hawks, was toured for a health and safety inspection. The facility operates from 7:00am – 6:00pm Monday – Friday.

The facility has ample age-appropriate materials in the classroom that was observed to be clean and in good condition. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. The two (2) children’s bathrooms are in good condition with ample number of sinks and toilets. All children have access to clean drinking water in the classroom. There are multiple fully charged fire extinguishers, carbon monoxide detectors, smoke detectors and first aid kits on site as well. There is a separate staff bathroom on site. Facility does not transport children but the children are picked up from Quail Run Elementary after school and walked over to the facility by a staff member. All children that do not attend Quail Run Elementary must be dropped off by their parent or authorized representative.

The on-site kitchen is clean, well maintained, and free from defects. All food on site is properly labeled and stored. Facility only provides snacks for the children. When children are present all day the children are required to bring their own lunch. All food that will be brought from the children’s home will be properly labeled and stored.


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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: 075700605
VISIT DATE: 10/07/2024
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The outside play yard is clean with ample age-appropriate materials for the children. The yard is fully fenced and has plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The facility is operating within its licensed capacity is in ratio. All staff working have obtained a criminal record clearance, exemption, or have transferred their clearances or exemption. The fire/disaster drill log is complete with the last drill logged 7/31/2024. A physical census of the children was taken and cross referenced with the sign-in and out log. All children have been signed in by facility staff. All required postings, including the menu, are posted in the hallway on the left side of the building. LPA obtained a sample of the children’s files, staff files, and the facility files. All files were complete.

No deficiencies cited during LPAs inspection.

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. 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. 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: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: 075700605
VISIT DATE: 10/07/2024
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 facility Director Ingrid Escalante.

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

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC809 (FAS) - (06/04)
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