197700901-1-2-2025-12-CC-CHEH-DCJPEU-20250102101543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700901
Report Date: 01/02/2025
Date Signed: 01/02/2025 10:16:11 AM

Document Has Been Signed on 01/02/2025 10:16 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	WELLS FAMILY CHILD CARE		FACILITY NUMBER:	197700901
ADMINISTRATOR/ DIRECTOR:	KELLIN WELLS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 793-1578
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	01/02/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:36 AM
MET WITH:	Licensee/Kellin Wells		TIME VISIT/ INSPECTION COMPLETED:	10:45 AM

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	On 1/2/2025, Licensing Program Analyst (LPA) Carol Heath announced a pre-licensing inspection with the applicant, Kellin Wells, to ensure the facility meets licensing requirements. The applicant is requested to provide care for a Large family childcare home with a capacity of 14 children. LPA toured the house in and out. Individuals who reside in the home include 3 adults (licensee, husband, 1 adult daughter) and no children. Per Guardian, all adults in this facility obtain a criminal record clearance and are associated with the facility. The applicant's hours of operation are Monday through Sunday, 23 hours. The incidental Medical Services (IMS) policy was discussed. The applicants will not provide IMS at this time. During today’s visit, the licensee’s grandsons are in town to visit. They will leave on Saturday. The home is described as follows: This one-story home consists of a 3-bedroom, 2-bathroom home with a kitchen, office, childcare (living/dining room), laundry/garage. There is no body of water on the premises. Childcare children can access the backyard. Main area: Main care is provided in the Living/Dining rooms used for childcare. Children use the bathroom between the bedroom and the laundry room on the right in the hallway.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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· Living/Dining room: A fireplace in the Living room is screened to make it inaccessible to the children. LPA observed a safety latch in front of the fireplace, made inaccessible to children. PA observed many age-appropriate toys, books, and other materials in the Dining room area. Per the applicants, the children will nap in the Family Room.
· Bathroom #1: Bathroom #1 was toured and inspected. The toilet and faucets are clean, safe, and in operable condition. The bathtub and shower area are free of hazards. There is some medication storage in the medicine cabinet. The applicants had a safety latch to make the materials inaccessible to the children.
· Kitchen/Dining: All sharp utensils, cutlery, cleaning supplies, medicines, drawers, cabinets with plastic bags, and pointy things or small things children can swallow are inaccessible to children with a child safety latch under the kitchen sink. The refrigerator, dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. Medications were stored in the off-limits bedroom.
· Outside: The backyard was inspected. It is completely fenced (brick). The patio and left-site outdoor area are accessible to the children. The right side is for dogs, which is inaccessible to the gate. Aloe vera and roses are screened in the planter area beside the brick wall. There is a gazebo and age-appropriate toys. LPA observed a refrigerator with water and juices. Applicants were always reminded to supervise children while playing in the backyard.
Off-limit area: The areas include all bedrooms, bathroom #2, pantry, laundry (safety knob), and garage.
· Bedrooms (Safety doorknobs ): The master bedroom (applicant and her husband), Bedroom #2 (daughter), and Bedroom #3 (office) have safety doorknobs to make the rooms inaccessible to the children.
· Bathroom #2 (Master Bathroom): Bathroom #2 is inside the master bedroom. LPA toured and inspected the medicine cabinet. The toilet and sink are in operable condition.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 2 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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· Laundry (Safety doorknob): The clean supplies and poison are in the laundry room. The garage door has a safety doorknob, which is inaccessible to children.
· Garage (safety doorknob): LPA inspected the garage. According to the applicant, it is off-limits for children, and no childcare activities will be conducted there. LPA observed a deadbolt door lock or (key lock) on the garage door.
Other:
AC/Heating Unit: The AC/Heating Unit is located on the right side of the home and is accessible access to the AC unit.
Bodies of water: According to the applicant, there were no bodies of water in the home. but a decorative water fountain did not have water.
Electrical outlets: All unused electrical outlets are plugged in and inaccessible to children.
Food: The applicant will enroll in the Food program. The applicant will provide Breakfast, lunch, snacks and dinner.
Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green. It is located in the kitchen and inaccessible to children. It meets standards established by the State Fire Marshal.
Fireplace: The fireplace was observed in the Family room and is screened to make it inaccessible to the children. LPA observed alcohol in the family room area. LPA reminded the licensee to make the area off-limit for all the children.
Hanging window blind cords: The cords are inaccessible to children.
Isolation area (Illness): Per the applicant, if the child shows signs of illness, they will be separated from other children.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 3 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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Medications and cleaning solutions: Detergents and cleaning compounds are in the upper kitchen cabinet, inaccessible to the children, and medications are in the off-limits bedroom.
Napping: Children will nap in designated areas (Family Room) with adult supervision. LPA observed 6 mats in the closet.
Overnight Care: According to the applicant, it does not provide overnight care.
Pet: There are 1 small dog. The has current vaccination.
Phone service: There is a working landline or cell phone.
Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
The first aid kit: The licensee will need to have a First aid supplies and a first aid manual.
Transportation: The applicant will Not provide transportation for children.
Weapons or Firearms: Per the applicant, there are No Firearms at the facility at this time. LPA does not observe any firearms.
Documentation:
The applicant's CPR and First Aid Training expires on 10/2026 and Prevented Health and Safety Training was completed on 10/14/24. She has her fingerprint clearance and TB exam. She has proof of being immunized against influenzas and Pertussis. The licensee still needs to have measles. She has proof of Mandated Reporting Training expires dated 12/3/2024. LPA shared LIC 311D with the applicant.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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The following was discussed with the applicant:
· [Applicant, Licensee, or Facility representative] was reminded that all adults 18 and over living in the home, persons who provide 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 licensed Family Child Care Home. 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.
· APPLICANT OWNS OR RENTS/LEASES THE HOME:
The [applicant, or licensee] provided proof of control of property.
· APPLICANT RENTS/LEASES THE HOME AND HAS LANDLORD CONSENT:
Because the [applicant, or licensee] rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).
· APPLICANT RENTS/LEASES THE HOME AND DOES NOT HAVE LANDLORD CONSENT:
The [applicant, or licensee] has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 [or 12] children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 [or 14] children.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 5 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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· APPLICANT KNOWS PROSPECTIVE CLIENTS WILL NEED IMS:
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) 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
· LPA discussed the safe sleep regulations with [applicant, licensee, or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at:
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· LPA reviewed with [applicant, licensee, or facility representative] the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.
· On this date, xx/xx/xxxx, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 6 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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· LPA discussed the safe sleep regulations with [applicant, licensee, or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· [Applicant, or Licensee] was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
· Notice of Site Visit (for licensed facilities only): A notice of site visit was given to [applicant, licensee or facility representative] and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
· Subscribe to CCLD important information: 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-care-licensing/subscribe and select the Child Care option to receive email communication.
o A baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety Code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 7 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

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o Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children's and provider's files and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The applicant was reminded that supervision is always required for children in care.
o The applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B.
o Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The applicant was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
o Requirements for fire drills, earthquake drills, and documentation for both.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
o The applicant is reminded that 100% supervision is required for children at all times.
o The applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits the smoking of tobacco in private residences that is licensed as a family childcare home and in those areas of the family childcare home where children are present (24/7 ban).

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

Page: 8 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WELLS FAMILY CHILD CARE	FACILITY NUMBER: 197700901
	VISIT DATE: 01/02/2025

NARRATIVE

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o 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.

Before being licensed, the following is required: Due 1-7-2025.

 AC unit is accessible to the children
 The licensee will need to get a fist aid kit.
 The TV wire is accessible to the children
 2 bookshelves need to be secure for the daycare area
 In the backyard, both site yard needs to make them inaccessible to children

**As a result of this inspection, the home does not meet Title 22 Regulations. Corrections are required.

An exit interview was conducted, and the report was reviewed with the licensee, Kellin Well

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

LIC809 (FAS) - (06/04)

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