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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417017
Report Date: 04/03/2024
Date Signed: 04/03/2024 11:43:32 AM

Document Has Been Signed on 04/03/2024 11:43 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:
ADMINISTRATOR/
DIRECTOR:		BANGALIE, FATMATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 866-9236
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
04/03/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
TIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:FATMATA BANGALIE, LICENSEETIME COMPLETED:
TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 4/3/2024 Licensing Program Analyst (LPA), Loyce Phillips conducted an unannounced Required Inspection and was met by Licensee, Fatmata Bangalie. LPA observed 6 children in care with Assistant. All adults have a criminal record clearance. Licensee is operating 24 hours. Licensee was reminded that staff must be awake when children are awake. The facility does not have liability insurance. Waiver are on file.

LPA toured inside and outside the facility. This is a 1 story home with 3 bedrooms, 2 bathrooms, living room, dining/kitchen area, family room, laundry room and detached garage.

The areas that are accessible to children: Living room, dining area/kitchen area, family room (main day care room), bedroom #3 (play room) and backyard for outdoor activities.

The areas that are off limits to children: Bedrooms #1, #2, bathroom #1, garage and extended backyard.

There is no swimming pool or other bodies of water on the premises. According to Licensee, there are no firearms or ammunition allowed or stored on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children.

There is a fully charged fire extinguisher located in the kitchen. The facility has a working smoke detector and carbon inside the home. The facility has adequate heating and ventilation for safety and comfort. Safe toys, materials and play equipment observed. LPA observed First Aid kit. Children nap on cots and infants sleep in cribs. The home has working telephone service and LPA confirmed the phone number is (323) 866-9236.

809-C

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BANGALIE FAMILY CHILD CARE
FACILITY NUMBER: 197417017
VISIT DATE: 04/03/2024
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

Licensee’s Mandated Reporter Training was completed on 3/14/2024. Licensee’s pediatric CPR/First Aid was completed on 3/9/2024.

This facility does not provides Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Safe Sleep - LPA discussed the safe sleep regulations with Licensee, Fatmata Bangalie 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 licensee 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 discussed infant safe sleep log and provided an example of a sleep log to Licensee. LPA explained and provided LIC 9227 Individual Infant Sleeping Plan to Licensee. LPA provided Licensee with LIC 9227.

809-C

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BANGALIE FAMILY CHILD CARE
FACILITY NUMBER: 197417017
VISIT DATE: 04/03/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

MyChildCarePlan.org – Licensee was informed of the MyChildCarePlan.org website; 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies are cited and technical advisories discussed with Licensee.

An exit interview was conducted, a copy of this report was read and provided to the Licensee. This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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Document Has Been Signed on 04/03/2024 11:43 AM - It Cannot Be Edited


Created By: Loyce Phillips On 04/03/2024 at 11:22 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BANGALIE FAMILY CHILD CARE
FACILITY NUMBER: 197417017

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview statement and record observation, the licensee did not comply with the section cited above in 1 out 1 safe sleep log for infant was not logged, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
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Licensee will use safe sleep log provided and log infant safe sleep everyday the infant naps. Licensee will place log in file.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record observation, the licensee did not comply with the section cited above in 3 out 3 employees did not have immunizations on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
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Licensee will obtain immunizations for all staff and place in employees file by POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karren Starks
LICENSING EVALUATOR NAME:Loyce Phillips
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024


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