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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073400985
Report Date: 05/18/2021
Date Signed: 05/18/2021 02:05:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ERNST, LYNNDIFACILITY NUMBER:
073400985
ADMINISTRATOR:ERNST, LYNNDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 672-9333
CITY:CLAYTONSTATE: CAZIP CODE:
94517
CAPACITY:14CENSUS: 11DATE:
05/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lynndi Ernst TIME COMPLETED:
02:15 PM
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On 5/18/21 at 1:30pm Licensing Program Analyst (LPAs) Michelle Sutton and Monica Mathur conducted an unannounced case management for a pool cover inspection. LPA met with licensee Lynndi Ernst and present for the inspection were licensee, husband and 11 children (1 infant, 1 school age, 9 preschool age). Licensee has a Large Child Care Home with a capacity of 14 children.

At 1:45pm LPA conducted an pool inspection for a pool cover and Licensee's husband walked across the pool cover. LPA reminded licensee to have 100% supervision when children are outside in the backyard.

At 2:00pm her assistant helper arrived at the facility. An exit interview was conducted, the report was discussed and signed. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
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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