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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343608219
Report Date: 04/26/2023
Date Signed: 04/26/2023 03:00:26 PM


Document Has Been Signed on 04/26/2023 03:00 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 POINTFACILITY NUMBER:
343608219
ADMINISTRATOR:STEPHANIE GILLFACILITY TYPE:
850
ADDRESS:9561 HARBOUR POINT DRIVETELEPHONE:
(916) 683-3244
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:120CENSUS: 120DATE:
04/26/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Stephanie GillTIME COMPLETED:
04:00 PM
NARRATIVE
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On 04/26/2023, 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 granted entrance. Director Stephanie Gill (D1) arrived at the facility shortly after LPA. LPA disclosed the purpose of the inspection to D1. LPA toured the Center and observed 120 preschool aged children being supervised by 6 staff members during nap time. LPA accessed Guardian to determine that required adults were background cleared and associated to the license. LPA determined that 1 of the 6 staff members was not associated to the facility's license. LPA also observed more than 24 children napping in a classroom with 1 staff member supervising.
As a result of the lack of association to the license and the exceedance of nap time ratio, 2 Type A deficiencies were cited on a subsequent 809-D page.
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: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2023
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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Document Has Been Signed on 04/26/2023 03:00 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 POINT
FACILITY NUMBER: 343608219

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/27/2023
Section Cited

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i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:...
(2) Request a transfer of a criminal record clearance as specified in Section 101170(f).
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D1 will submit a Transfer Request or have the staff member obtain a Livescan. D1 will email proof of Transfer or LIvescan to LPA by closing on 04/27/2023. D1 will call Officer of the Day OR print out Guardian to show a clerance for the individual BEFORE the staff member returns to work.
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Based on LPA observation and record review, D1 did not ensure that a staff member had been associated to the facilty's license before her employemnt at the facillity which poses an immediate health, safety and or personal rights risk to children in care.
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Type A
04/27/2023
Section Cited

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Each center shall provide a variety of daily activities designed to meet the needs of children in care, including but not limited to:..(c) A teacher-child ratio of one teacher supervising 24 napping children is permitted provided that the remaining teachers necessary to meet
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D1 will create and disseminate a Memo on rules and Regulations of nap time ratios. All staff members will sign an aknowlegement of the Memo. The Memo and Signature Page will be emailed to LPA by closing on 04/27/2023.
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the overall ratio specified in Section 101216.3(a) are immediately available at the center.
Based on LPA observation, more than 24 children were napping in a classroom with 1 staff member supervising nap time.
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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: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2023
LIC809 (FAS) - (06/04)
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