434400323-7-26-2022-52-CC-MESA-CGPR28-20220726123755

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400323
Report Date: 07/26/2022
Date Signed: 07/26/2022 12:38:12 PM

Document Has Been Signed on 07/26/2022 12:38 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MERRYHILL SCHOOL 1071		FACILITY NUMBER:	434400323
ADMINISTRATOR:	DARICE JOHNSON		FACILITY TYPE:	850
ADDRESS:	123 CORNING AVENUE		TELEPHONE:	(408) 946-2812
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	78	CENSUS: 26	DATE:	07/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Darice Johnson		TIME COMPLETED:	12:45 PM

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	On Tuesday, July 26, 2022 at 9:20 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year visit. LPA met with the Principal / Director Darice Johnson and explained the nature of site visit. Present on this visit were 6 staff and 26 preschool children. Facility operates from Monday to Friday 7 AM to 6 PM. LPA toured the facility to conduct a Health and Safety Inspection. Facility has a current waiver for Children's Sign in and Out. Facility’s License, Parents’ Rights Poster, Personal Rights, Waiver and Activity Schedules were observed to be posted. LPA observed to be following teacher to children ratio requirement. Children were engaged in various activities under the visual supervision of the teachers. The preschool classrooms (Beginners, Intermediate and Pre-K), children's and staff restroom and kitchen, were inspected. Director stated that facility does not possess nor store any weapons on the premises. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Furniture and equipment such as mats, cots, tables, and chairs were age appropriate and were in good condition, free of sharp, loose, or pointed parts. Restrooms for children's use and staff were observed to be in safe, sanitary, and functioning condition. 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. There were shaded rest areas for children. Drinking water are arranged to be readily available to children during indoor and outdoor activities. Food and beverages were kept protected against contamination and spoilage. Menu was posted. Kitchen and food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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 1071	FACILITY NUMBER: 434400323
	VISIT DATE: 07/26/2022

NARRATIVE

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Continuation.

Facility files were reviewed. Children's sign in and out procedures, logs were reviewed, and LPA obtained copies of Children's sign in and out dated 7/21,22 and 27/2022. A random sampling of Children's files was selected for review. The records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, and Immunization.

A random sampling of Staff's files was selected for review. The records reviewed include: Criminal Record and Child Abuse Index Clearance, Health Screening Report with TB Clearance, Education Qualification and records of immunization (Measles, Pertussis, and only Influenza - may be declined and an annual requirement). Staff have their AB1207 Mandated Reporter Training Certifications in their file. LPA reminded Director that the training needs to be renewed every two years. There was at least one person with documented training on preventive health practices, including current certification in Pediatric CPR and First Aid present at the facility.

Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. LPA observed First Aid Kits. Milpitas Fire Department had their inspection on 07/20/2022 and Fire Permit expires on 12/31/2022. LPA reviewed Disaster Drills, Fire Drill and Earthquake Drills last conducted 7/20/2022.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

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 1071	FACILITY NUMBER: 434400323
	VISIT DATE: 07/26/2022

NARRATIVE

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Continuation.

LPA obtained copies of the Facility's LIC 9040, LIC 500 and most recent Lead Sampling Report.

LPA discussed the PIN 22-10-CCP UPDATED GUIDANCE FOR CHILD CARE PROVIDERS REGARDING CORONAVIRUS DISEASE (COVID-19).

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

There are no deficiencies cited on this visit.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Darice Johnson.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

LIC809 (FAS) - (06/04)

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