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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700903
Report Date: 07/18/2023
Date Signed: 07/18/2023 03:38:22 PM


Document Has Been Signed on 07/18/2023 03:38 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.270
SACRAMENTO, CA 95833



FACILITY NAME:EHIMAS RESIDENTIAL CAREFACILITY NUMBER:
342700903
ADMINISTRATOR:EHIMAMIEGHO, JUSTICE OSASEFACILITY TYPE:
740
ADDRESS:407 MAPLE STREETTELEPHONE:
(916) 912-8042
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY:15CENSUS: 12DATE:
07/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Justice EhimamieghoTIME COMPLETED:
04:00 PM
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On 7/18 at approximately 1pm Licensing Program Analysts (LPAs) Maja Jensen, Jennifer Fain and a department auditor arrived at the facility to conduct a solvency and trust audit entrance conference. LPAs Jensen and Fain and the auditor met with Licensee Justice Ehimamiegho and his accountant and explained the purpose of the visit.

The auditor advised the Licensee of the allegations that triggered the audit. The Licensee's accountant spoke to the auditor on 7/14/23 and requested an extension to provide documents for the solvency audit which was granted through 7/20/23.

The auditor and LPA Jensen reviewed the contents of a facility safe with the Licensee and reviewed 9 of 12 resident files.

Due to time constraints this audit will be continued tomorrow, 7/19/23.

An exit interview was conducted and a copy of this report was handed to Licensee Justice Ehimamiegho.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023
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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