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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700903
Report Date: 08/23/2023
Date Signed: 08/23/2023 02:45:11 PM


Document Has Been Signed on 08/23/2023 02:45 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



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: 13DATE:
08/23/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Justice EhimamieghoTIME COMPLETED:
10:50 AM
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An office meeting was held today via Microsoft Teams with the Sacramento South Regional Office. The purpose of this meeting was to discuss the Technical Support Program Engagement Summary (TSP) generated on 7/28/2023. Present at this meeting were Licensing Program Manager (LPM) Liza King, Licensing Program Analyst (LPA) Jennifer Fain, Heidi Allen- Intensive Placement Team for Sacramento County & CCLD Liaison, and representing Ehimas was Licensee Justice Ehimasmiegho.

LPM and LPA discussed the following topics previously addressed at the TSP Engagement:

· Care and Supervision

· Personnel/ Training

· Food Services

Licensee reported that they have implemented the following as a result of TSP involvement:

· Staff meetings and staff training occur once a month on the second and last Sundays, respectively.

· Trainings have been completed, including but not limited to: Safe Serve, Fall Prevention, and Mandated Reporting

· Resident Council meetings were attempted, especially to discuss the menu, but there was little resident interest

Licensee requests assistance with SIR training. LPM King will coordinate with TSP. LPA Fain will send link to Training Requirements PIN to Licensee.

The RO will continue to conduct quarterly monitoring and provide any TA needed.

No citations were issued today. An exit interview was conducted with Justice Ehimamiegho and a copy of this report was emailed to Justice with a request to return with signature to Jennifer.fain@dss.ca.gov.

SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Jennifer FainTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2023
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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