434400319-4-18-2023-07-CC-PHEZ-CQZRQX-20230418131416

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400319
Report Date: 04/18/2023
Date Signed: 04/18/2023 01:14:24 PM

Document Has Been Signed on 04/18/2023 01:14 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MERRYHILL SCHOOL 1072		FACILITY NUMBER:	434400319
ADMINISTRATOR:	BILBRO, HEATHER		FACILITY TYPE:	830
ADDRESS:	750 NORTH CAPITOL AVENUE		TELEPHONE:	4082541280
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95133
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 32	CENSUS: 20	DATE:	04/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Heather Blibro		TIME COMPLETED:	01:35 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	Licensing Program Analyst (LPA) Pete Hernandez conducted an unannounced Required 1 Year inspection of the Infant center today. LPA met with Director Heather Bilbro and Office Administrator Vanessa Chavez and explained the purpose of today's visit. Facility’s License, Parents’ Rights Poster, Personal Rights, Activity Schedules, and Waivers were observed to be posted. Facility's operating days and hours are Monday to Friday 7:00 AM to 6:00 PM. There are active waivers on file for: 1. Electronic sign in/sign out system 2. Allow transfer for infants to preschool at age 23 months. Facility was observed to be in compliance with teacher to children ratio requirement during LPAs' inspection. Children were engaged in various activities under the visual supervision of the teachers. The classrooms used are PURPLE ROOM for Infants and BLUE ROOM for Toddler age. Purple Room 3 Teachers and 9 Children Blue Room: 3 Teachers and 11 Children The physical plant was inspected. LPA toured the building with the Director. Restrooms, pantry, storage room, and office area were inspected. Director stated that facility does not possess nor store any weapons on the premises. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Floors were clean and free from tripping hazard. The Facility is cleaned by a third party janitorial service. Continued on Page 2. Report dated4/18/2023

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MERRYHILL SCHOOL 1072	FACILITY NUMBER: 434400319
	VISIT DATE: 04/18/2023

NARRATIVE

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Continued from Page 1. Report dated 04/18/2023

Outdoor activity space was inspected and observed to be safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

Food and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair.

Director stated that facility does / does not handle medications and currently have children in care who require Incidental Medical Services. Facility has an approved IMS Plan on file with San Jose Regional Office. LPA reviewed storage of medication and equipment / supplies. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.
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.

Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles.

LPA observed a 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, fire pull stations, and sprinkler system. Log shows that the last Fire Drill was conducted on 3/7/2023.

A sampling of 10 Children's files and 5 Staff files was taken for review. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. The Director has a current CPR/First Aid card that expires on 3/2024.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MERRYHILL SCHOOL 1072	FACILITY NUMBER: 434400319
	VISIT DATE: 04/18/2023

NARRATIVE

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LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Director was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

Website for provider resources: http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates
childcareadvocatesprogram@dss.ca.gov

"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

A deficiency is NOT being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted with the licensee. A copy of this report was discussed and left with the Licensee, Heather Bilbro, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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