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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304204382
Report Date: 05/01/2019
Date Signed: 05/01/2019 12:48:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MEYER, LYNETTEFACILITY NUMBER:
304204382
ADMINISTRATOR:MEYER, LYNETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 459-0981
CITY:RANCHO STA MARGARITASTATE: CAZIP CODE:
92688
CAPACITY:14CENSUS: 8DATE:
05/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Licensee and her assistantTIME COMPLETED:
01:15 PM
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An inspection was conducted at the facility by Licensing Program Analyst (LPAs) Mahnaz (Nancy) Malek and LPA Mila Quinto. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

According to licensee, there are presently one other adult living in the home. During today’s inspection the home and grounds were toured and the licensee was operating within the licensed capacity. Present during today's inspection was the licensee, Lynette Meyer and her assistant, Jennifer Hoertig. There were eight children present of whom three were under two years old. The floor plan was verified. Off limits areas are made inaccessible to children by means of baby gates and latches. Fire place was screened and inaccessible to children. The main day care area is the family room next to the kitchen area. The licensee's pediatric CPR/First Aid certification is current. Items which could pose a danger to children were not accessible to children. Poisonous items were not observed during today's inspection. There is carbon monoxide detector in the house. The smoke detector was tested. Appropriate fire extinguisher is in the house. Licensee has a current roster of children in care. Emergency Disaster drill log within the past six months was available. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's inspection. The backyard is completely fenced. The outdoor play area is free from hazards. There is no high climbing structure/slide equipment observed in the back yard. There is no body of water. There was a small one tier water fountain without water was observed with a drain on the bottom.
Children's records: parents' rights and California School Immunization Record were reviewed.
Two dogs (Golden Retriever and Labrador were observed in the house. Garage is not accessible to children and was locked and latched.

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SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 703-2810
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MEYER, LYNETTE
FACILITY NUMBER: 304204382
VISIT DATE: 05/01/2019
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, a Plan for Providing 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

There is proof of immunization against pertussis and measles and Flu vaccines for the licensee and her assistant in the house. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” and Never shake a baby pamphlet were provided to the licensee on the last inspection. An updated pamphlet regarding safe sleep regulations in childcare and a pamphlet for lead poisoning facts were given today.
Mandated Reporter Training certificate were available for licensee and her assistant.


Exit interview was conducted. Report reviewed and discussed with the licensee. Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal rights provided and explained. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report. Licensee was informed how/where to access regulations and forms from CCLD website: www.ccld.ca.gov.

On today's inspection, no deficiencies of the California Code of Regulations, Title 22; Division 12 were observed.

SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 703-2810
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2