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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153904497
Report Date: 08/07/2019
Date Signed: 08/07/2019 11:50:50 AM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LYNAM, MICHELLE FAMILY CHILD CAREFACILITY NUMBER:
153904497
ADMINISTRATOR:LYNAM, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 587-2588
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:14CENSUS: 5DATE:
08/07/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michelle Lynam - Licensee TIME COMPLETED:
12:00 PM
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An unannounced Annual/Random Inspection was conducted today by Licensing Program Analysts (LPA) Jessika Thompson and Diana Meracdo. LPAs met with Licensee Michelle Lynam, and a census was taken. Also present during the inspection was licensee’s assistant, Zoe Crandall. A tour of the facility was made. Background clearances were discussed and licensee signed LIS531 indicating all adults residing and/or providing care and supervision have a criminal record clearance. Licensee has current pediatric CPR and First Aid that expire on 12/21/19. The home is clean and orderly, with heating and ventilation for safety and comfort. Off-limit rooms are made inaccessible by use of door knob covers and child proof gates. Where children less than five years old are in care, stairs are fenced or barricaded. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. There is a working telephone. Licensee has three large dogs that are made inaccessible to children by means of gated areas in backyard and inaccessible areas of the home. License accepts full liability for any action taken by family pets. A current roster of children in care is maintained and updated appropriately. LPAs verified that immunization records are maintained. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representative. Licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. Confirmed firearms are stored in accordance with regulations and inaccessible to children. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. There is a fireplace that is not used during day-care hours. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. No bodies of water observed in or on the premises. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants was discussed and LPAs provided the licensee with a handout. Lead safety was discussed, and LPAs provided Licensee with a brochure. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and licensee is aware that forms and updated information may be obtained on the CCLD website (www.ccld.ca.gov).
(Continued on LIC809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: LYNAM, MICHELLE FAMILY CHILD CARE
FACILITY NUMBER: 153904497
VISIT DATE: 08/07/2019
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Incidental Medical Services (IMS) policy was discussed. Licensee stated currently she does not have any children enrolled requiring IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee has proof of Child Abuse Mandated Reporter training, completed 09/2018. Hours of operation are Monday through Friday from 6:30 AM to 5:45 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice. Licensee is advised that forms and updated information may be obtained on the CCLD website (www.ccld.ca.gov). Licensee is also advised that it is her responsibility to stay current with regulations.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
LIC809 (FAS) - (06/04)
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