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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570311280
Report Date: 03/24/2025
Date Signed: 03/24/2025 12:18:04 PM

Document Has Been Signed on 03/24/2025 12:18 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MERRYHILL SCHOOL - LA VIDAFACILITY NUMBER:
570311280
ADMINISTRATOR/
DIRECTOR:		ALEXIS MONTANTESFACILITY TYPE:
850
ADDRESS:222 LA VIDA WAYTELEPHONE:
(530) 753-9210
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 88TOTAL ENROLLED CHILDREN: 88CENSUS: 55DATE:
03/24/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Melanie SaephonTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On March 24, 2025, Licensing Program Analyst (LPA) Lauren Scott met with Facility Representative, Melanie Saephon, to follow up on an Unusual Incident Report (UIR) that was reported to Community Care Licensing on 03/07/2025.

The facility reported the UIR to Community Care Licensing within 24hrs and submitted a written UIR within 7 days.

LPA interviewed the staff who were present during the incident and obtained information pertinent to the investigation. LPA reviewed and discussed this report with the facility representative.

Facility evaluation report was reviewed and discussed with facility representative, Melanie Saephon. An exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Scott informed facility representative, Melanie Saephon, that this report dated 03/24/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Scott informed the facility representative to provide a copy of this licensing report dated 03/24/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Chayntel HunterTELEPHONE: (916) 917-8620
Lauren ScottTELEPHONE: (916) 926-9488
DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2025
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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Document Has Been Signed on 03/24/2025 12:18 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: MERRYHILL SCHOOL - LA VIDA
FACILITY NUMBER: 570311280

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2025
Section Cited
CCR
101223(a)(1)

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(a) The licensee shall ensure that each child is accorded the following personal rights:
(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by:
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Facility will conduct a staff meeting regarding children's personal rights, the meeting with include how to appropriately speak with children and how to change diapers. Staff members will sign the meeting notes and submit to CCLD by POC date
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Based on interviews conducted, LPA learned at least one staff forcefully held a child on the changing table while attempting to change a diaper and at times had aggressive tones/ words. This poses an immediate health, safety, or personal rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Chayntel HunterTELEPHONE: (916) 917-8620
Lauren ScottTELEPHONE: (916) 926-9488

DATE: 03/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2025

LIC809 (FAS) - (06/04)
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