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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750196
Report Date: 06/04/2025
Date Signed: 06/04/2025 03:41:02 PM

Document Has Been Signed on 06/04/2025 03:41 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KLEVER KIDZ CHILDCARE CENTERFACILITY NUMBER:
197750196
ADMINISTRATOR/
DIRECTOR:		LISET DOYLEFACILITY TYPE:
860
ADDRESS:44275 DIVISION ST.TELEPHONE:
(661) 434-3584
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
06/04/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH: Wellzina Fernandez, ApplicantTIME VISIT/
INSPECTION COMPLETED:
01:26 PM
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Licensing Program Analyst (LPA) Maddox met with Wellzina Fernandez, Applicant for the purpose of conducting an announced pre-licensing inspection. Applicant is requesting licensure of 16 Toddlers (18 - 36 mos), 16 Preschool 3-5 yrs); and 16 School-age (5 - 13) children. The hours of operation will be: Sun through Friday from 6:00 am to 8:00 pm. Center consist of 3 classrooms, office space, kitchen, 1 staff bathroom, and 1 children's bathroom. During this inspection, LPA measured the 3 classrooms and the outdoor area.

INDOOR ACTIVITY SPACE:

· The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors


· Floors of all rooms have a surface that is safe and clean (tile flooring with area rugs)
· A comfortable temperature for children shall always be maintained.
· Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys, and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
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· Tables and chairs were present to meet the needs of the children.
· Drinking water is readily available - Water dispenser
· Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children ( Stored in closet next to office)
· There are fully stocked first-aid kit(s) in locations accessible to staff but inaccessible to children
· The isolation area is located in the office for any child who becomes ill during the day.
· LPA observed operable carbon monoxide detectors and smoke detectors (both hard wired and replaceable), fire extinguishers are located throughout the facility and fully charged.
· The center has a working telephone
· Sign-in and out procedure (care connect app and manually).
· Staff shall conduct a wellness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
OUTDOOR

Children have safe access to the play yard which is enclosed by a fence to protect children and to keep them in the outdoor activity area. There are no bodies of water present. Outside Drinking Water - Igloo

RESTROOMS

There is 1 children's bathroom present with 3 sinks and 3 toilets. All toilets and hand washing facilities were maintained. safe, and sanitary operating condition.

pg #2

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
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Measurements taken were as follows:
Room #1
702/35 = 20
Room #2
771/35 = 22
Room #3
345 (classroom) + 134 (computer area) = 479/35 = 14
TOTAL INDOOR SPACE: 56

Bathroom:
There are 3 toilets and 3 sinks in 1 bathroom = 45

Outside play space:
1486 (back area) + 533 (front area) = 1,802/75 = 24
SUPERVISION:

Applicant shall ensure no child is left without the supervision of a teacher at any time, Supervision shall include visual observation.

TRANSPORTATION:

Applicant states she will provide transportation.

CHILDREN’S RECORDS:


LPA reviewed with Applicant form LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
Pg #3
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
NARRATIVE
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FOOD SERVICES

Menu must be posted for parents’ review.

· Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored.


· Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies.
· Food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.
· Trashcans, including moveable bins, shall have a tight fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

· A refrigerator is available and shall be used to store any medication that requires refrigeration.

CRIMINAL RECORD REVIEW


Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
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NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
NARRATIVE
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NAPPING

· Cots and mats will be used for napping


· Each cot/mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child.
· LPA informed Applicant Cots/mats should be wiped with a detergent/disinfectant weekly or when soiled or wet.
· Bedding shall be individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. - Cubby needed
· Napping equipment shall be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children.

HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children. Applicant states she will dispense prescription medications and over the counter meds.

Applicant has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (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 - Applicant states the center will not provide IMS at this time. Page #7

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
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LEAD TESTING

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP)

POSTINGS:

Applicant was informed of the required forms that shall be posted after licensure including the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication

LPA informed Applicant of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.



Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KLEVER KIDZ CHILDCARE CENTER
FACILITY NUMBER: 197750196
VISIT DATE: 06/04/2025
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Fire Clearance has been received for the requested capacity of 48 children (Toddlers, Preschool, and School-age children), however, upon inspection, there's only 1 children's bathroom present, no separate bathroom for components. Applicant has decided not to follow through with the Toddlers at this time, and will decide if she wants to keep all PS children or not, either way updated forms will be required (LIC 999). The maximum capacity that could be approved at this time would be 45 due to toilets and sinks available for children.

Needed Prior to Licensure:

The outside area was not set up to accept children, there were no outdoor play toys or equipment nor adequate outdoor shade. Updated LIC 999. Barrier around the bottom portion of pole on the play yard; Pop-up shade; benches removed; Cubbies; thermometer for first aid kit, Outdoor play schedule, updated Parent Handbook excluding Toddlers and School-age. Final review of updated paperwork received. Applicant has a licensed FCCH, she will decide and inform LPA via form LIC855 - Declaration of her decision to keep it open or to close it. Applicant is aware she must be present at the licensed FCCH %80 and she must be the primary caregiver.

An exit interview was conducted with the above items discussed and a copy of this report was provided to the Applicant, Wellzina Fernandez. Director packet has been verified for Magda Akhnoukh. Applicant was informed additional information may be required as she navigates through the licensing process. Final license determination will be made upon review of the Licensing Program Manager.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Donna Maddox
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC809 (FAS) - (06/04)
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