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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623332
Report Date: 10/16/2020
Date Signed: 10/16/2020 05:20:34 PM

Document Has Been Signed on 10/16/2020 05:20 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BANAHENE, TANIKAFACILITY NUMBER:
343623332
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
10/16/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Tanika BanaheneTIME COMPLETED:
02:00 PM
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On Friday, 10/16/20 at 12:30pm, Licensing Program Analyst (LPA), Jan Hoshida, met with Licensee, Tanika Banahene, via Zoom due to COVID-19 pandemic, for the purpose of an increase of capacity inspection. Licensee had applied to change from a Small Family Child Care Home to a Large Family Child Care Home. LPA observed that there were five day care children and her assistant in the home. The off-limits areas in the home are bedrooms #4 and #5. Licensee acknowledged that children may never enter the off-limit areas. Licensee acknowledged that if she would like to change an off-limits area to on-limits, she will inform LPA prior to using the space for inspection and approval. Licensee stated there are no new residents in the home since licensure. All adult residents have criminal record clearances. Hours of operation are Monday through Friday from 7:30am to 6:00pm.

During the Zoom inspection, LPA Hoshida requested a tour of the facility. LPA and Licensee conducted a health and safety inside and out the home. A fire bell, functioning smoke and carbon monoxide detectors and fire extinguisher were observed in the home. The Fire Safety Inspection Clearance has been received and the home has been cleared as of 10/9/20.

LPA observed that there were no hazardous items accessible to children. Licensee stated that she understands that any poisons must be kept under lock and key. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Toys appear to be safe. The backyard is fenced and gated. Current pediatric CPR and first aid training was verified and expires on 8/2021. The fireplace was properly screened and inaccessible to children. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some files.

REPORT CONTINUED ON NEXT PAGE
Bettina Engelman
Jan Hoshida
DATE: 10/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2020
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: BANAHENE, TANIKA
FACILITY NUMBER: 343623332
VISIT DATE: 10/16/2020
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This facility evaluation report was reviewed and discussed with the Licensee. Records, postings and reporting requirements were discussed. Licensee was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, self-assessment guides, regulations and legislation pertaining to family child care homes. LPA also included the email address for the children's advocacy program to stay current on new laws CHILDCAREADVOCATESPROGRAM@DSS.CA.GOV.

Effective today 10/16/20, facility is approved for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family child care home. An exit interview was conducted and Notice of Site Visit was provided.

Facility evaluation report was emailed to Licensee and an email verification of receipt of report will be used in lieu of a signature on this report.
SUPERVISOR'S NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2020
LIC809 (FAS) - (06/04)
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