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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343608219
Report Date: 04/10/2023
Date Signed: 04/10/2023 05:18:44 PM


Document Has Been Signed on 04/10/2023 05:18 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:MERRYHILL SCHOOL-HARBOUR PT.FACILITY NUMBER:
343608219
ADMINISTRATOR:STEPHANIE GILLFACILITY TYPE:
850
ADDRESS:9561 HARBOUR PT. DRIVETELEPHONE:
(916) 683-3244
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:120CENSUS: 115DATE:
04/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Amanda TamanahaTIME COMPLETED:
05:30 PM
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On 04/10/2023, Licensing Program Analyst Katy Maestas (LPA) conducted a field visit to the facility for the purpose of a case management inspection. LPA arrived at the facility and was met by Assistant Director Amanda Tamanaha (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA toured the Center and observed 115 preschool aged children being supervised by 10 staff members. LPA accessed Guardian to determine that all required adults were background cleared and associated to the license. LPA conducted staff interviews, requested a copy of the Facility Roster and observed children's files. No deficiencies were cited during today's visit.
An exit interview was conducted and the report was reviewed with D1. Licensee Appeal Rights were provided to D1 by LPA. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2023
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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