570311280-6-18-2021-53-CC-CHUR-C44S26-20210618132902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 570311280
Report Date: 06/18/2021
Date Signed: 06/18/2021 01:29:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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-LA VIDA		FACILITY NUMBER:	570311280
ADMINISTRATOR:	ASHLEY TOBUREN		FACILITY TYPE:	850
ADDRESS:	222 LA VIDA WAY		TELEPHONE:	(530) 753-9210
CITY:	DAVIS	STATE: CA	ZIP CODE:	95618
CAPACITY:	88	CENSUS: 0	DATE:	06/18/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Principal, Ashley Toburen		TIME COMPLETED:	01:45 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	Licensing Program Analyst (LPA) Chayntel Hunter met with Principal, Ashley Toburen for the purpose of an unannounced Annual/Random inspection. The facility is licensed to serve 76 preschoolers and 12 toddlers age 18-36mos (with parent permission) under a toddler option program. There were no children present during today's inspection. LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 6:30 AM to 6:00 PM. LPA reviewed care and supervision of children, staffing ratios, medications and first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, there is sufficient cushioning under the play structure. LPA reviewed the electronic sign in/out tablet and observed that the children are properly signed in/out. All staff present during today's inspection have a fingerprint clearance. LPA observed health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid. LPA observed AB1207 mandated reporter training certificates for all staff. The Principal was reminded to renew the course every 2 years through www.mandatedreporterca.com website. During the inspection LPA reviewed new COVID19 self-assessment guide and conducted a technical assistance tour of the facility to incorporate Department of Public Health safety protocols for operating during the pandemic. LPA reviewed posting requirements and facility operations including sanitation and pick up/drop off procedures. Report continues on 809-C.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MERRYHILL SCHOOL-LA VIDA	FACILITY NUMBER: 570311280
	VISIT DATE: 06/18/2021

NARRATIVE

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LPA verified annual fees were current.

Incidental Medical Services (IMS) policy was discussed. Facility has a plan in place.

Incidental Medical Services (IMS) policy was discussed. Facility has a plan in place. 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

This facility evaluation report was reviewed and discussed with the Principal. An exit interview was conducted. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. The Principal was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC809 (FAS) - (06/04)

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