364845953-3-23-2023-09-CC-SLOZ-CQ7QNW-20230323121949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364845953
Report Date: 03/23/2023
Date Signed: 03/23/2023 12:19:55 PM

Document Has Been Signed on 03/23/2023 12:19 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	GODDARD SCHOOL, THE		FACILITY NUMBER:	364845953
ADMINISTRATOR:	NATASHA ABUATA		FACILITY TYPE:	850
ADDRESS:	16258 POMONA RINCON RD		TELEPHONE:	(909) 308-5800
CITY:	CHINO HILLS	STATE: CA	ZIP CODE:	91709
CAPACITY: 132	TOTAL ENROLLED CHILDREN: 125	CENSUS: 34	DATE:	03/23/2023
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	08:51 AM
MET WITH:	Director Natasha Abuata		TIME COMPLETED:	12:30 PM

NARRATIVE

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On 3/23/2023, Licensing Program Analysts (LPAs) Samuel Lopez and Rachel Zeron arrived at the facility to conduct an inspection for an unrelated issue. During the inspection, LPA Lopez toured the facility to obtain a census and verify that staff on site had a Criminal Record Clearance. LPA Lopez observed a staff member providing Care and Supervision to children in care that had not obtained a Criminal Record Clearance.

See LIC809-D for cited deficiency.

Director Natasha Abuata was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

LPA Samuel Lopez informed the Director Natasha Abuata that this report dated March 23, 2023 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GODDARD SCHOOL, THE	FACILITY NUMBER: 364845953
	VISIT DATE: 03/23/2023

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Also, LPA Samuel Lopez informed the Director Natasha Abuata to provide a copy of this licensing report dated March 23, 2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Director Natasha Abuata.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/23/2023 12:19 PM - It Cannot Be Edited

Created By: Samuel Lopez On 03/23/2023 at 11:23 AM

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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GODDARD SCHOOL, THE	FACILITY NUMBER: 364845953
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/23/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/24/2023 Section Cited CCR 101170(e)(1)	1 2 3 4 5 6 7	Criminal Record Clearance - All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department.	1 2 3 4 5 6 7	Staff was sent home during the inspection. Director agrees to submit a written plan as to how the facility will be and maintain compliance with cited regulation. Plan to be submitted to the Riverside Child Care Regional Office by 3/24/2023.
	8 9 10 11 12 13 14	Based on observation and record review, the facility did not meet the regulation above. Staff without a Criminal Record Clearance/exemption was providing care and supervision to children in care. This poses an immediate risk to the Health, safety, and personal rights to the children in care.	8 9 10 11 12 13 14	Please note that there is a $500.00 civil penalty attached to this citation.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Aaron Ross

LICENSING EVALUATOR NAME:

Samuel Lopez

LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC809 (FAS) - (06/04)

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