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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617610
Report Date: 05/12/2023
Date Signed: 05/12/2023 09:45:19 AM

Document Has Been Signed on 05/12/2023 09:45 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:MERRYHILL SCHOOL - POCKETFACILITY NUMBER:
343617610
ADMINISTRATOR:SUSAN FREITAGFACILITY TYPE:
850
ADDRESS:7335 PARK CITY DRIVETELEPHONE:
(916) 424-2299
CITY:SACRAMENTOSTATE: CAZIP CODE:
95831
CAPACITY: 170TOTAL ENROLLED CHILDREN: 170CENSUS: 146DATE:
05/12/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Terrie CookTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 9:00am and met with Director Terrie Cook regarding an Unusual Incident that took place April 19, 2023. LPA made observations and interviewed the director.

LPA observed that the facility was in compliance with Title 22 regulations and the Health and Safety Code at time of inspection.

LPA consulted the facility regarding proper use of the Toddler option.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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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