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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619917
Report Date: 09/08/2023
Date Signed: 09/08/2023 10:06:24 AM

Document Has Been Signed on 09/08/2023 10:06 AM - 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MAJU, FATMATA BINTAFACILITY NUMBER:
343619917
ADMINISTRATOR:MAJU, FATMATA BINTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 896-8657
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
09/08/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Fatmata Binta MajuTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Fatmata Binti Maju on 9/8/23 for the purpose of an unannounced plan of correction inspection to clear the Type A deficiencies, which were issued on 08/31/2023.

Licensee did not have any children present during today’s visit. LPA toured the facility and found no deficiencies.



The uncleared adult’s fingerprints have been cleared with Guardian as of 9/8/23. Knife and weed killer have been removed. Carbon monoxide detector and smoke detectors have been purchased and in working order. Fire extinguisher is not the correct size and that deficiency cannot be cleared today. Licensee will purchase the correct fire extinguisher and send LPA a picture of the device and receipt. Once LPA receives the information, LPA can clear the deficiency.

3 out of 4 Deficiencies cited on 08/31/2023 are cleared effective today. Proof of correction letters were provided to Licensee. LPA reviewed report with Licensee, Fatmata Binti Maju. Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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