434400322-6-18-2019-52-CC-TDON-BD9NDG-20190618102218

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400322
Report Date: 06/18/2019
Date Signed: 06/18/2019 10:22:24 AM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MERRYHILL SCHOOL 1070		FACILITY NUMBER:	434400322
ADMINISTRATOR:	LEW, VIOLA		FACILITY TYPE:	850
ADDRESS:	1500 YOSEMITE DRIVE		TELEPHONE:	(408) 945-9090
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	50	CENSUS: 0	DATE:	06/18/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Viola Lew and Michele Martinez		TIME COMPLETED:	10:30 AM

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	Licensing Program Analyst (LPA) Tuoc Doan conducted an unannounced Annual inspection of the Preschool. LPA met with Preschool Director Viola Lew and Head Teacher Michele Martinez, and explained the purpose of the visit. Upon arrival, LPA was informed that the Preschool has ceased operation sine 05/28/19. Director and Head Teacher informed LPA that the Preschool has not been enrolling children since 05/28/19 and is planning to close the Preschool. LPA reviewed with Director the procedure to follow to close the Preschool or put the Preschool license on inactive status. Facility will maintain communication with Licensing Office regarding the status of the Preschool operation. LPA inspected the areas licensed for Preschool operation. The two Classrooms, restrooms, playground, hallway, and Office space were inspected. The Preschool classroom is located in Room 2 and Room 3 on Merryhill Elementary School Campus. The Preschool has been granted a waiver to allow Preschool children to use the Elementary school playground for Kindergarteners. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Carbon Monoxide Detector was tested and proved to be functioning. Fire extinguishers were last serviced on 03/2019. LPA observed that there are first aid kits and the building has a fire alarm pull system. Record shows that the building had an inspection by the Milpitas Fire Department on 02/21/19. Director and Head Teacher Michele Martinez's files were reviewed. Both have current AB1207 Mandated Reporter Certifications, and Pediatric CPR/1st Aid Certifications that expire on 05/30/2020. Both files are complete with the required records such as Criminal Record and Child Abuse Index Clearance, Health Screening Report with TB Clearance, and proof of immunity against Measles and Pertussis. Director has a current Child Development Site Supervisor Permit issued by the CA Commission on Teacher Credentialing.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MERRYHILL SCHOOL 1070	FACILITY NUMBER: 434400322
	VISIT DATE: 06/18/2019

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LPA reminded facility of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

In the areas that were evaluated, no regulatory violations were observed at the time of the visit.

Exit Interview was conducted, where this report was reviewed and discussed with Preschool Director.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

LIC809 (FAS) - (06/04)

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