393615579-2-24-2021-53-CC-JSMH-BYR3JU-20210302171804

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393615579
Report Date: 02/24/2021
Date Signed: 02/24/2021 04:10:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/01/2020 and conducted by Evaluator Fabiola Diaz

COMPLAINT CONTROL NUMBER: 53-CC-20201201094140

FACILITY NAME:	MERRYHILL SCHOOL-TRINITY		FACILITY NUMBER:	393615579
ADMINISTRATOR:	TAMARA WELLS		FACILITY TYPE:	850
ADDRESS:	10250 TRINITY PARKWAY		TELEPHONE:	(209) 474-0518
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY:	163	CENSUS: 76	DATE:	02/24/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Tamara Wells		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Other- Staff did not report incidents to the child's authorized representative.

INVESTIGATION FINDINGS:

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A tele-inspection was conducted at the facility in lieu of an on-site visit, due to the recent COVID-19 State of Emergency. Licensing Program Analysts (LPAs) Fabiola Diaz and Gagandeep Singh spoke with Director, Tamara Wells and with Pauline Maloy to deliver the findings of the complaint investigation regarding the above allegation. LPA Diaz conducted staff and parent interviews and reviewed records pertaining to the above allegation. The evidence obtained revealed that Child #1’s parents and the Department were not notified in a timely manner of an unusual incident regarding an allegation made involving Staff #1 and Child #1.
Based on LPA’s interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An Exit Interview was conducted in which the report was reviewed and discussed with Director. A copy of this report was e-mailed to the Director. In lieu of a signature due to COVID-19, LPA Diaz requested that the Director acknowledge receipt of this report via e-mail. Director stated she will also provide LPA Diaz with a signed copy of this report.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 53-CC-20201201094140

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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-TRINITY	FACILITY NUMBER: 393615579
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/24/2021 Section Cited CCR 101212(f)	1 2 3 4 5 6 7	101212 Reporting Requirements (f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director has already informed Child #1's parents of the unusual incident. Director provided LPA Diaz with the written Unusual Incident Report (UIR) on 2/24/21. Director and LPA Diaz discussed Title 22 reporting requirements.
	8 9 10 11 12 13 14	Based on interviews and record reviews, Director did not ensure to notify Child #1's parents and the Department in a timely manner of an unusual incident regarding an allegation made involving Staff #1 and Child #1.	8 9 10 11 12 13 14	POC will be cleared as of today 2/24/2021.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/01/2020 and conducted by Evaluator Fabiola Diaz

COMPLAINT CONTROL NUMBER: 53-CC-20201201094140

FACILITY NAME:	MERRYHILL SCHOOL-TRINITY		FACILITY NUMBER:	393615579
ADMINISTRATOR:	TAMARA WELLS		FACILITY TYPE:	850
ADDRESS:	10250 TRINITY PARKWAY		TELEPHONE:	(209) 474-0518
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY:	163	CENSUS: 76	DATE:	02/24/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Tamara Wells		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Personal Rights- Staff treated the daycare child inappropriately.
Personal Rights- Staff are not protecting children from a child's biting behaviors.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 53-CC-20201201094140

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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-TRINITY	FACILITY NUMBER: 393615579
	VISIT DATE: 02/24/2021

NARRATIVE

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It was alleged that staff are not protecting children from Child #1's biting behaviors. Based on interviews and record reviews the facility has a policy in place for children who bite. However, despite efforts to manage Child #1's biting behaviors the staff have not been able to mitigate the problem. Recently, the Director implemented a different strategy and Director stated Child #1 has improved and the parents have received more positive feedback. Based on the evidence could neither prove nor disprove the allegation that children are not being protected from Child #1’s biting behaviors.

Although the above allegations may have happened (or are valid), there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the findings are UNSUBSTANTIATED. No deficiencies were cited regarding the above allegations. An Exit Interview was conducted in which the report was reviewed and discussed with Director. A copy of this report was e-mailed to the Director. In lieu of a signature due to COVID-19, LPA Diaz requested that the Director acknowledge receipt of this report via e-mail. Director stated she will also provide LPA Diaz with a signed copy of this report.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

LIC9099 (FAS) - (06/04)

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