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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364845954
Report Date: 05/09/2023
Date Signed: 05/11/2023 01:42:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2023 and conducted by Evaluator Rachel Zeron
COMPLAINT CONTROL NUMBER: 09-CC-20230316142637
FACILITY NAME:GODDARD SCHOOL, THEFACILITY NUMBER:
364845954
ADMINISTRATOR:NATASHA ABUATAFACILITY TYPE:
830
ADDRESS:16258 POMONA RINCON RDTELEPHONE:
(909) 308-5800
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:36CENSUS: 8DATE:
05/09/2023
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Natasha Abuata TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff did not follow infant's feeding plan resulting in an allergic reaction


Staff did not prevent infants from being injured by other infants in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rachel Zeron made an unannounced visit to complete a complaint investigation. The complaint was received in the regional office on 03/16/2023. LPA met with Natasha Abuata, Director. The following was alleged: staff did not follow infant's feeding plan resulting in an allergic reaction and staff did not prevent infants from being injured by other infants in care . Complaint indicated that staff the child was given sour cream and had an allergic reaction, also that the child had been bit adn scratched by other children. Complaint also indicated that the child also bites other children and that was the reason for the termination. Staff LPA reviewed records/documents, interviewed staff, and made direct observations of teacher to child ratios in all functioning classrooms.
During the investigation, LPA Zeron reviewed facility documentation, conducted interviews with relevant individuals pertinent to this investigation. Records review revealed that C1's allegies to dairy were documented and interviews conducted with staff indicated that staff were aware of C1's allergies and skin rashes associated with the allergies, staff denies having served any dairy products to C1. Staff also indicated that the facility does not serve sour cream, staff disclosed that C1 did have strawberries on the day that C1 broke out in a rash on the face, C1's responsible party was notified, strawberries were not listed on C1's allergy list.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 09-CC-20230316142637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: GODDARD SCHOOL, THE
FACILITY NUMBER: 364845954
VISIT DATE: 05/09/2023
NARRATIVE
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Regarding the allegation, staff did not prevent infants from being injured by other infants in care. LPA conducted interviews and records reviews, based on interviews conducted, staff indicated that C1 had a hard time communicating and would bite and hit other children on numerous occasions, resulting in C1 biting three times, three different children on the day the facility terminated C1. LPA compared and verified staff interviews to the incident reports on file at the facility, incidents were documented as indicated. LPA did find that C1 was bitten on 02/08/2023, and had two scratch reports on file with the facility. LPA observed facility to be in ratio and did not witness any violent behavior between children in care.

Therefore, due to conflicting information found throughout this investigation this agency has investigated the complaint allegations. 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. DIRECTOR WAS INSTRUCTED TO POSTED IT IN A PROMINENT LOCATION AT THE FACILITY. THE DIRECTOR UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.
An exit interview was conducted, A copy of this report and appeal rights were given to the Director, Natasha Abuata.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2