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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 570311281
Report Date: 09/15/2021
Date Signed: 09/15/2021 01:35:29 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/16/2021 and conducted by Evaluator Chayntel Hunter
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20210816112244
FACILITY NAME:MERRYHILL SCHOOL-LA VIDAFACILITY NUMBER:
570311281
ADMINISTRATOR:ASHLEY TOBURENFACILITY TYPE:
830
ADDRESS:222 LA VIDA WAYTELEPHONE:
(530) 753-9210
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY:16CENSUS: DATE:
09/15/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Principal, Ashley ToburenTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: A child was bitten by a child in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Chayntel Hunter spoke with Principal, Ashley Toburen to deliver the findings of the complaint investigation regarding the above allegation. During the course of the investigation, LPA Hunter conducted interviews, reviewed the facility's biting policy and obtained information pertaining to the allegation. It was alleged that a child was bitten by another child (C1) while in care.

Through interviews conducted and review of records, it was determined that there were two confirmed biting incidents by C1. Although there were two confirmed biting incidents, there was not enough evidence to prove that the facility did not attempt to redirect the biting. Principal explained that multiple staff had been brought on to prevent biting incidents. 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 finding is UNSUBSTANTIATED. Exit interview was conducted. Appeal rights were printed and provided. Notice of Site Visit was provided and should remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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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