364845953-9-22-2026-09-CC-CATN-DY6PYL-20260922114407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364845953
Report Date: 09/22/2026
Date Signed: 09/22/2026 11:48:23 AM

Document Has Been Signed on 09/22/2026 11:48 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	GODDARD SCHOOL, THE		FACILITY NUMBER:	364845953
ADMINISTRATOR/ DIRECTOR:	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: 129	CENSUS: 0	DATE:	09/22/2026
TYPE OF VISIT:	Office	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:21 AM
MET WITH:	Licensee Nan Song & Director Natasha Abuata		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On the date a time listed above an Informal Conference was held at the Riverside Regional Office. Present in the conference were Licensee Nan Song, Director Natasha Abuata, Licensing Program Manager (LPM) Ana Noble, and Licensing Program Analyst (LPA) Chase Atherton. The Purpose of the meeting was to review and discuss the following: • 101229 Responsibility for Providing Care and Supervision • 101226.3 Observation of the Child • 101226 Health-Related Services • 101223 Personal Rights • 101216 Personnel Requirements Facility representatives stated they have trained their staff in regards to the above regulations and are implementing the following steps: • A form in each teacher's room that shows zones where the teacher is to stand in order to provide full supervision during outdoor play. • They have ongoing staff training and include supervision training in monthly training. • The Director conducts one-on-one meetings with staff if needed. • They have an additional staff member to follow up with teachers regarding their use of zones outdoors, daily. • They have decreased the amount of children in the outdoor area at one time to reduce risks. • They have trained their staff regarding personal rights. • They conducted training with staff members regarding identifying child injuries and health related services.

Ana Noble
Chase Atherton
	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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

FACILITY NAME: GODDARD SCHOOL, THE	FACILITY NUMBER: 364845953
	VISIT DATE: 09/22/2026

NARRATIVE

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• They have implemented a new form for all vendors that explains the requirements for vendors while working at the facility.

Facility Representatives were advised to visit the Department's website at: https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers

Facility Representatives were also advised to visit the Department's video regarding supervision at: https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/

A link to resources and additional videos can be found on the Community Care Licensing website at: https://ccld.childcarevideos.org/

A link to the Provider Information Notices can be found on the Community Care Licensing website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

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 platform. To receive important licensing related information to licensed facilities, visit the CCLD Important Information website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe

Technical Support Program (TSP) was discussed with the facility representives and were encouraged to voluntarily enroll or seek training from an outside vendor in the areas discussed during this informal conference. The facility representatives were provided with the following: TSP Brochure, TSP Information Page, a printed copy of California Code of Regulations (CCR) section 101226.3 Observation of the Child, CCR 101223 Personal Rights, CCR 101229 Responsibility for Providing Care and Supervision, CCR 101226 Health-Related Services, and CCR 101216 Personnel Requirements.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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

FACILITY NAME: GODDARD SCHOOL, THE	FACILITY NUMBER: 364845953
	VISIT DATE: 09/22/2026

NARRATIVE

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Facility representatives Nan Song & Natasha Abuata, were also encouraged to contact Resources and Referrals Agency (Pomona Unified School District 800-822-5777 and 909-397-4740 ext. 25030) for additional resources and training pertaining to Observation of the Child, Personal Rights, Responsibility for Providing Care and Supervision, Health-Related Services, and Personnel Requirements.

The facility representatives understand that not remaining in compliance can lead to additional administrative actions.

Facility representatives were informed to provide a copy of this licensing report dated 9/22/2026 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 children's parents/guardians for the next 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 facility representatives Nan Song & Natasha Abuata.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

LIC809 (FAS) - (06/04)

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