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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570311281
Report Date: 06/18/2021
Date Signed: 06/18/2021 01:30:09 PM

Document Has Been Signed on 06/18/2021 01:30 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MERRYHILL SCHOOL-LA VIDAFACILITY NUMBER:
570311281
ADMINISTRATOR:ROBIN SWEENEYFACILITY TYPE:
830
ADDRESS:222 LA VIDA WAYTELEPHONE:
(530) 753-9210
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 16TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/18/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Principal Ashley ToburenTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Chayntel Hunter met with Principal, Ashley Toburen for the purpose of an unannounced Annual/Random inspection. 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 were cribs available for each infant under 12 months old and cots available for infants over 12 months old. LPs observed a changing table within arm's reach of the sink. LPA observed individual sleeping plans for children in care. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure for the toddlers appeared to be in good repair, there is sufficient cushioning under the play structure to prevent the fall.

LPA reviewed the electronic sign in/out tablet and observed that the children are properly signed in. LPA reviewed children’s and staff files. 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 for all staff members. At least one staff member present today has current Pediatric CPR and First Aid. LPA observed AB1207 mandated reporter training for all staff. The Principal was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

Report continues on 809-C.
SUPERVISORS NAME: Sharon Ogbodo
LICENSING EVALUATOR NAME: Chayntel Hunter
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: 570311281
VISIT DATE: 06/18/2021
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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.

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 Director 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.
SUPERVISORS NAME: Sharon Ogbodo
LICENSING EVALUATOR NAME: Chayntel Hunter
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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