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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417017
Report Date: 07/30/2026
Date Signed: 07/30/2026 01:50:57 PM

Document Has Been Signed on 07/30/2026 01:50 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BANGALIE FAMILY CHILD CAREFACILITY NUMBER:
197417017
ADMINISTRATOR/
DIRECTOR:		BANGALIE, FATMATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 866-9236
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/30/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Licensee, Fatmata BangalieTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
NARRATIVE
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On 07/30/2026, Licensing Program Analyst, LPA, Tyra Chavies conducted an unannounced Case Management Visit- Deficiency at Bangalie FCCH. LPA Chavies toured the facility and met with licensee, Fatamata Bangalie. There were 6 children being supervised and cared for by 3 staff members.

On 07/29/2026 Licensing Program Analysts, LPAs, Tyra Chavies and Patsy Plancarte, observed the following

Between 1:30 PM - 3:30 PM LPAs observed the following:

As LPA's were walking up, licensee was walking out of home around 2:00 PM to go get "Ice Cream" for the children in care.

Around 2:05 PM LPA's toured childcare and observed the primary area to be unkept. LPA Chavies requested the licensee to tidy up to ensure the childcare remains safe for the safety & welfare of children in care. Licensee and husband both became aggressive with their tone with LPA Chavies and preceded to yell at LPA Chavies and used inappropriate language.

At 2:15 pm LPA Chavies contacted LPM Neal to consult about the untidiness of the facility and the licensee tone and behavior regarding LPA Chavies observations. LPM Neal spoke to licensee and advised licensee of the inspection and asked licensee if she had additional questions for LPM Neal. LPA Chavies

Karren Starks
Tyra Chavies
DATE: 07/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2026
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BANGALIE FAMILY CHILD CARE
FACILITY NUMBER: 197417017
VISIT DATE: 07/30/2026
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provided LPM Neal photos of the untidiness. During this inspection LPM spoke to the licensee at least 3 times regarding the observations and her need to comply for the safety and welfare of children in care. LPM explained to licensee due to time limitations LPA Chavies would return to the facility to assess the citations. LPM Neal informed licensee if any of the violations were observed to be corrected the LPA would still be required to cite accordingly and then clear those violations via the LIC 809 report. Licensee stated she understood.

Around 2:25 PM LPAs took pictures of the Bangalie FCCH. LPAs observed no toys in the primary care area. 2 younger children were observed sitting on the floor and a chair. A third school-age child sitting watching the younger 2 children. Licensee husband observed sitting in a nearby chair.

Around 2:40 PM LPAs observed child 2 (C2) climb onto the table, sit on a chair on the top of the table and jump off causing C2 to fall on the wooden floor. C2 then ran into the off-limits area while Licensee was on a private telephone call with back turned to C2.

LPA advised licensee of the following, The licensee shall provide care and supervision as necessary to meet the children's needs, the home shall be kept clean and orderly, the home shall provide safe toys and licensee is to ensure the home be free from conditions which might endanger a child.

The licensee is being cited Two type B's and One type A. Please see (LIC 809-D)

LPA Tyra Chavies informed Licensee, Fatama Bangalie, that this report dated 07/30/2026

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BANGALIE FAMILY CHILD CARE
FACILITY NUMBER: 197417017
VISIT DATE: 07/30/2026
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document 1 Type A citation, which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

LPA Tyra Chavies informed the licensee to provide a copy of this licensing report dated 07/30/2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/09/2026 02:51 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/20/2026 08:26 AM


Created By: Tyra Chavies On 07/30/2026 at 01:26 PM
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
EL SEGUNDO CC RO, 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: 07/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2026
Section Cited
CCR
102423(a)(2)

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102423(a)(2) Personal Rights To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by: C2 observed climbing onto a table & jumping & falling onto the wooden floor.
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Licensee will submit a written action plan regarding keeping children safe & supervised. Review Supervising Children in Family Child Care Video and provide LPA with written action on what was learned from the video.

The plan is due by 07/30/26 email to tyra.chavies @dss.ca.gov or postal mail to El Segundo CCP 300 Continental #290-A El Segundo 90245
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C2 ran to an off-limits area. Licensee was on the phone with back turned to C2. This is care & supervision concern and a personal rights violation. This is a health and safety concern and poses an immediate health, safety or personal rights risk to persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Tyra Chavies
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2026


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 09/09/2026 02:47 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/20/2026 08:27 AM


Created By: Tyra Chavies On 07/30/2026 at 01:29 PM
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
EL SEGUNDO CC RO, 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: 07/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2026
Section Cited
CCR
102417(b)

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102417(b) Operation of a Family Child Care Home The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement is not met as evidenced by: LPAs observed the following: Door off the hinge, 2nd door covered in black
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Licensee will correct all the items identified ensuring the home is clean, orderly, odor free, with ventilation for safety and comfort.

Due by 08/06/26. LPA conduct an inspection to observe the home and backyard.
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markings & chain on door not working door was still ajar, wood exposed door. Cereal & sticky floor. Bathroom toilet unflushed observed with soiled toilet paper, shower door accessible and shower floor unclean, suitcases, laundry baskets in the hallway, broken playpen, rug with soiled spots, hole in a wall, garage door open & accessible hazards ladder & unused fridge in backyard. Pungent smell in FCCH which poses/posed a potential health, safety or personal rights risk to persons in care.
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 Due by 08/06/26. LPA conduct an inspection to observe the home and backyard.
Type B
07/30/2026
Section Cited
CCR102417(d)

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102417(d)Operation of a Family Child Care Home The home shall provide safe toys, play equipment and materials. This requirement is not met as evidenced by: Based on observations LPAs did not observe any toys for children in care.
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which poses a potential health, safety or personal rights risk to persons in care.
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Licensee will remove broken toys and damaged items, licensee shall provide age-appropriate & safe toys, books, cots for all day-care children receiving services, Licensee shall ensure there is a shaded area for the children during outdoor play. Due date 08/06/26LPA will conduct an inspection to observe the home.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Tyra Chavies
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2026


LIC809 (FAS) - (06/04)
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