393615579-6-8-2023-53-CC-CHUR-CSMW5L-20230609165918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393615579
Report Date: 06/08/2023
Date Signed: 06/08/2023 04:16:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/26/2023 and conducted by Evaluator David Nguyen

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20230526092815

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: 64	DATE:	06/08/2023
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Tammy Wells		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Facility staff hit child(ren) in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), David Nguyen conducted an unannounced field visit to deliver the finding for the above allegation. LPA arrived at the facility and was met by Principal, Tammy Wells. LPA disclosed the purpose of the inspection and was granted entrance. LPA toured the facility and observed sixty-four (64) children being supervised by ten (10) adults.

It was alleged that the “Facility staff hit child(ren) in care.” During the investigation, LPA, Nguyen inspected the facility and interviewed the Principal, Teachers, Parents, and Children. Based on the information obtained throughout the course of this investigation, the above allegation could not be substantiated or dismissed.

Report contunues on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: David Nguyen	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

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-20230526092815

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERRYHILL SCHOOL-TRINITY	FACILITY NUMBER: 393615579
	VISIT DATE: 06/08/2023

NARRATIVE

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During the interviews, LPA Nguyen found conflicting information regarding the allegation that facility staff may have hit a child or children in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted in which the report was reviewed and discussed with the Principal. LPA provided a copy of the report and Appeal Rights to the Principal. A Notice of Site visit was posted by LPA and Licensee understands it must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00.

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: David Nguyen	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

LIC9099 (FAS) - (06/04)

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