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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625093
Report Date: 09/25/2024
Date Signed: 09/25/2024 02:50:51 PM

Document Has Been Signed on 09/25/2024 02:50 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BAGCI, MUSAFACILITY NUMBER:
343625093
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/25/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Musa BagciTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the licensee, Musa Bagci, for a case management inspection. The licensee has applied for a capacity increase from eight to fourteen children in care.

During today’s inspection, LPA inspected the facility. LPA observed there is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. The house is in good repair and free of hazards with proper temperature and ventilation. There is a variety of age appropriate toys in the house. A fire inspection of the house has been scheduled for September 30. During inspection, LPA discussed the regulations and requirements of the large license. A handout, with information of capacity and ratio, was provided during the inspection. Licensee understood that while operating as large, there must be an assistant/helper with licensee.

During today’s inspection, LPA did not observe any hazard in the house. LPA informed the licensee that Large license (with maximum capacity of fourteen children in care) will granted after the Department received the approval from the fire department. Copy of this report was reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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