343600372-9-29-2021-53-CC-EWOS-C7BU4H-20210929151509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343600372
Report Date: 09/29/2021
Date Signed: 09/29/2021 03:15:15 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	MERRYHILL SCHOOL-LAGUNA PARK		FACILITY NUMBER:	343600372
ADMINISTRATOR:	NORRIS, LISA		FACILITY TYPE:	850
ADDRESS:	6613 LAGUNA PARK DRIVE		TELEPHONE:	(916) 684-4044
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	116	CENSUS: 66	DATE:	09/29/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Karina Medina		TIME COMPLETED:	03:20 PM

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 September 29, 2021 at 12:45 PM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual/Random Inspection and met with Director, Karina Medina. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were sixty six (66) preschool age children present during this inspection and twenty additional staff members. The facility consist of five (5) classrooms. The facility was toured inside and out for a health and safety inspection. The hours of operation are 6:30 AM-6:00 PM, Monday -Friday CLASSROOMS: Five classrooms was inspected. There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the director's office away from other children in care. The center has wired smoke detectors, a carbon monoxide detector, working telephone, pull down fire alarm system, and four (4) fully charged 3A40BC fire extinguishers. BATHROOMS AND TOILETING AREAS: The staff's bathrooms are separate from the children's bathrooms. All sinks and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. FOOD SERVICE AREAS: This facility provide snacks for the children. There are monthly/weekly menus posted at the facility. LPA observed an area were they have a refrigerator this area is clean and free of evidence of rodents. Lunch is provided to children in care by the center. All storage containers for solid waste have tight fitting covers that are in good repair. See 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 229-4549
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MERRYHILL SCHOOL-LAGUNA PARK	FACILITY NUMBER: 343600372
	VISIT DATE: 09/29/2021

NARRATIVE

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OUTDOOR PLAY AREAS: There's a play structure with a slide that has cushioning to absorb falls. There's also a canopy that provides shade to children while at play.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Ten (10) children's files and four (4) staff files were reviewed around 1:30 PM. All children files have required Immunization Records, Medical Consent forms and Parents Rights. All staff files have required Health Screening, Employee Rights, and Criminal Record Statements. LPA reviewed the facility roster and obtained a copy. At least one opening/closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director's CPR and First Aid certificate is current and expires on 08/2023. The center is in compliance with the sign in and out procedure.

Disaster drills are being conducted at least once every 6 months and the last one was conducted on 09/16/21. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: IMS is being provided at this facility. LPA inspected the medication, which is stored in a safe place that is inaccessible to children in care. Each of the medications has an unaltered label with the child’s name and date of issuance. The center is equipped with a fully stocked first aid kit that are available in the classrooms.

California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

See 809-C.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 229-4549
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MERRYHILL SCHOOL-LAGUNA PARK	FACILITY NUMBER: 343600372
	VISIT DATE: 09/29/2021

NARRATIVE

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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Facility representative 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.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Karina Medina.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 229-4549
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

LIC809 (FAS) - (06/04)

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