393615623-11-7-2023-53-CC-DNGN-CXD2GG-20231107162306

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393615623
Report Date: 11/07/2023
Date Signed: 11/07/2023 04:23:12 PM

Document Has Been Signed on 11/07/2023 04:23 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	MERRYHILL SCHOOL - TRINITY		FACILITY NUMBER:	393615623
ADMINISTRATOR:	TAMARA WELLS		FACILITY TYPE:	830
ADDRESS:	10250 TRINITY PARKWAY		TELEPHONE:	(209) 474-0518
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 31	DATE:	11/07/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Tammy Wells		TIME COMPLETED:	04:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On November 7th, 2023, at 9:15 AM, Licensing Program Analyst (LPA) David Nguyen met with Principal, Tammy Wells for the purpose of an unannounced Annual inspection. The purpose of the unannounced annual inspection was explained. There were thirty-one (31) children present at the start of today's inspection. LPA toured the facility inside and out. LPA observed that hazardous items, including disinfectants and cleaning solutions, were inaccessible to children in care. Facility days and hours of operation are Monday through Friday from 6:30 AM to 6:00 PM. Meals—AM snack, Lunch, and PM snack—are provided to childcare children. Filtered water was provided to childcare children for drinking water. LPA verified annual license fees are current. LPA reviewed care and supervision of children, staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed a changing table within arm's reach of the sink. 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 (artificial grass) under the play structure to prevent the falls. LPA observed all required forms to be posted. There are needs and services plans for each infant and toddler enrolled. LPA observed proper storage of refrigerated bottles which were dated and labeled with children's names. LPA reviewed the sign in/out computer printouts and observed that the children are properly signed in. Report continues on 809-C...(Page 2)

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERRYHILL SCHOOL - TRINITY	FACILITY NUMBER: 393615623
	VISIT DATE: 11/07/2023

NARRATIVE

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LPA discussed the safe sleep regulations with principal and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the principal of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended the principal register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA discussed with the principal the requirement to check and log infant napping every 15 minutes, for infants under 24 months. LPA provided a copy of LIC 9227 Individual Infant Sleeping Plan, for infants under 12 months. LPA also discussed with the principal the requirement to complete the LIC 9227 Individual Infant Sleeping Plan for infants under 12 months. LPA observed two (2) Individual Infant Sleeping Plans for infants under 12 months of age and five (5) sleep logs for infants under 24 months of age.

LPA reviewed children’s and staff files. All staff present during today's inspection have a fingerprint clearance. Principal was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA observed health screening reports with TB test and required MMR and TDAP vaccines. Two (2) out of ten (10) staff members had immunization records on files. At least one staff present today has current Pediatric CPR and First Aid. LPA discussed the requirement for 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 LIC809-C....(Page 3)

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERRYHILL SCHOOL - TRINITY	FACILITY NUMBER: 393615623
	VISIT DATE: 11/07/2023

NARRATIVE

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This provider is not currently providing Incidental Medical Services (IMS) services to children in care. IMS policy was discussed. 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

LPA discussed the Year-Round/Daily Reminder of Water Safety Requirements and Measures with principal. LPA provided principal the PIN 23-17-CCLD, the Year-Round and Daily Reminder of Water Safety Requirements and Measures.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the principal, Tammy Wells. A notice of site visit was provided and must remain posted for 30 days. Principal’s signature on this form acknowledges receipt of this form. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, LPA Nguyen informed Principal, Tammy Wells that this report dated November 7th, 2023 documents two (2) Type B citations during today’s inspection.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/07/2023 04:23 PM - It Cannot Be Edited

Created By: David Nguyen On 11/07/2023 at 03:46 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MERRYHILL SCHOOL - TRINITY	FACILITY NUMBER: 393615623
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/08/2023
	Plan of Correction
1 2 3 4	Principal agrees to obtain the teachers' immunization records by the due date of the plan of correction (12/8/2023).

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/08/2023
	Plan of Correction
1 2 3 4	Pricipal agrees to obtain the teachers' Certificates of Completion for Child Care Providers Mandated Reporter Trainings by the due date of plan of correction (12/8/2023).

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Chayntel Hunter

LICENSING EVALUATOR NAME:

David Nguyen

LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

LIC809 (FAS) - (06/04)

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