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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417017
Report Date: 03/24/2023
Date Signed: 03/24/2023 11:23:27 AM

Document Has Been Signed on 03/24/2023 11:23 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BANGALIE FAMILY CHILD CAREFACILITY NUMBER:
197417017
ADMINISTRATOR:BANGALIE, FATMATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 866-9236
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/24/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:FATMATA BANGALIE, LICENSEETIME COMPLETED:
11:40 AM
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On 3/24/2023, Licensing Program Analyst (LPA) Loyce Phillips, conducted a case management inspection to follow up on an Unusual Incident reported to the department by telephone on 3/17/2023. LPA was greeted by Licensee Fatmata Bangalie, toured the facility and took a census of the children. Upon arrival, there were 2 children present today.

Description of the incident: On 3/16/2023, Licensee reported C1 parents called S2 and asked what happen at the day-care, because C1 had blood in her underwear. Parent stated she asked C1 what happen and C1 stated C2 did it. C1 father took child to the hospital for an examination. Licensee called the child abuse hot line to report the incident.

During this inspection, LPA toured the facility, inspected the indoor/outdoor day care area, interviewed staff, obtained Identification/emergency information form. LPA requested a copy of the facility roster.

Based on the information provided and interviews conducted the incident will require further investigation.

An exit interview was conducted, a copy of this report and notice of site visit was provided to Licensee

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
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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