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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623338
Report Date: 03/18/2025
Date Signed: 03/18/2025 11:03:33 AM

Document Has Been Signed on 03/18/2025 11:03 AM - 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MERRYHILL SCHOOL - ROCKLINFACILITY NUMBER:
313623338
ADMINISTRATOR/
DIRECTOR:		MELISSA MOENNINGFACILITY TYPE:
850
ADDRESS:5893 STANFORD RANCH ROADTELEPHONE:
(916) 624-4511
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 156TOTAL ENROLLED CHILDREN: 156CENSUS: 63DATE:
03/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Nancy FugateTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with licensing representative Nancy Fugate for an unannounced Licensee Initiated Case Management Inspection. LPA observed 63 children supervised by 12 staff members.

It was reported that on 03/13/2025, a child jumped from a play structure and injured their foot at the facility. Initially the child did not show signs of injury, however the child was taken to the emergency room later in the evening and diagnosed with a sprained ankle. While at the facility, the child was attended to by staff after they observed the child had been hurt on the playground.

During today’s inspection, LPA interviewed staff and observed the play structure and playground where the incident occurred.

No deficiencies were observed.

LPA reviewed this report with licensing representative Nancy Fugate and conducted an exit interview. LPA provided a Notice of Site Visit that shall remain posted for 30 days.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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