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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845903
Report Date: 08/04/2023
Date Signed: 08/04/2023 02:49:46 PM

Document Has Been Signed on 08/04/2023 02:49 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SANGANI FAMILY CHILD CAREFACILITY NUMBER:
334845903
ADMINISTRATOR:SANGANI,DAXAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(208) 854-9490
CITY:EASTVALESTATE: CAZIP CODE:
92880
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
08/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Daxa SanganiTIME COMPLETED:
03:00 PM
NARRATIVE
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On 08/04/23@ 1:40 p.m. Licensing Program Analysts (LPAs) Blanca Ruiz and Elyse Jones arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matter(s) that was discovered during inspection. LPAs met with licensee, Daxa Sangani and licensee's assistant. During the inspection, LPAs conducted a tour of the facility and census was taken. Upon arrival to the facility, 7 children were observed napping in the living room area, one of them was an infant. Child #1 was observed in deep sleep in a play pen with a blanket. Licensee stated that Child #1 is new at the facility and today is Child’s#1’s third day in daycare. Per licensee statement child is adapting to the daycare and blanket was an object while left for the child to adapt to the new environment. Licensees acknowledges and agrees to comply with Safe Sleep Regulation and to work closely with the child to sleep without blanket.

Please See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.

Exit interview was conducted and report was reviewed with licensee, Daxa Sangani. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2023
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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Document Has Been Signed on 08/04/2023 02:49 PM - It Cannot Be Edited


Created By: Blanca Ruiz-Silva On 08/04/2023 at 02:28 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SANGANI FAMILY CHILD CARE
FACILITY NUMBER: 334845903

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/11/2023
Section Cited
CCR
1012425(b)

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(b) Cribs or play yards shall be free from all loose articles and objects. This requirement was not met as evidenced by:
Based on the observation, the Licensee did not meet the above regulation which poses a potential Health, Safety & Personal rights to the children in care.
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Licensee agrees to read the regulation and submit a statement of understanding to the Department on or by 8-11-2023. Safe Sleep Regulations were provided during the isnpection.
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During the facility tour LPAs observed C1 sleeping with a blanket. LPA explained the Safe Sleep regulations to the Licensee. Licensee stated the child is new and is using the blanket as a safety net but she understands the risk and will not allow him to use the blanket.
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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.
SUPERVISOR'S NAME:Aaron Ross
LICENSING EVALUATOR NAME:Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2023


LIC809 (FAS) - (06/04)
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