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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629155
Report Date: 08/26/2021
Date Signed: 08/26/2021 12:55:34 PM

Document Has Been Signed on 08/26/2021 12:55 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BANGENYI, FLORENCE FAMILY CHILD CAREFACILITY NUMBER:
376629155
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/26/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Florence Bangenyi, Applicant TIME COMPLETED:
01:15 PM
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On 08/26/2021 at 11:45 a.m., Licensing Program Analyst (LPA) Michelle Hood conducted an announced pre-licensing inspection with applicant. This 4-bedroom, 2 bath home was toured and inspected to ensure environment is safe for the care and supervision of children.

Applicant provided proof of control of property for review by the Department. Applicant will use the following areas for child care: living room, sitting room, bathroom #1 and left side of the backyard. Off limits areas include: kitchen, dining room, bedrooms 1-4, bathroom #2, garage and rear and right side of the backyard. They are made inaccessible to day care children through the use of doorknob covers, safety gates and door latches. The living room fireplace is barricaded. There are no bodies of water observed during time of visit. The fire extinguisher, smoke and carbon monoxide detectors meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces.

Children’s toys and play equipment are available. Applicant stated there are NO firearms or other weapons in the home. Applicant has completed the 8 hours of preventative health and lead. Pediatric CPR and First Aid certifications expire on 06/2023. Required documents are posted. Applicant has been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and are in compliance for applicant. Per applicant operating hours are Monday through Sunday 6:00 a.m. to 6:00 p.m. Advised applicant no changes should be made to the home without prior notice and/or approval from Licensing. Applicant stated they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. Applicant completed the Mandated Reporter AB1207 training.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2021
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: BANGENYI, FLORENCE FAMILY CHILD CARE
FACILITY NUMBER: 376629155
VISIT DATE: 08/26/2021
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Applicant does not plan on providing IMS to clients at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The New Provider Resource Packet was reviewed with the applicant including information on the following: SIDS, shaken baby, insurance, child abuse reporting, community resources, children’s records, facility records, required postings, immunization's, unusual incident report, roster, car seat law, visual for ratio/capacity, fire/disaster drill log, effects of lead exposure, and PIN 20-04 CCP. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. LPA and Applicant discussed Safe Sleep, California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Applicant will request to be on the distribution list for child care updates. Go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and click “subscribe.”

The maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

The following corrections are needed prior to the issuance of the regular license:
1. Backyard gate to separate the rear and right side of the backyard
2. Transfer of applicant's spouse fingerprints

Once proof is received by the licensing agency, a Small Family Child Care Home License for 8 may be issued upon a final file review.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
LIC809 (FAS) - (06/04)
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