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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700903
Report Date: 10/25/2023
Date Signed: 10/25/2023 05:24:50 PM


Document Has Been Signed on 10/25/2023 05:24 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: DATE:
10/25/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Justice EhimamieghoTIME COMPLETED:
01:00 PM
NARRATIVE
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Sacramento South Regional Office held an office meeting via Microsoft teams on 10/25/23 at 11:00 AM. The purpose of the meeting was to discuss Solvency and Trust Audit Report Findings. Present in today's meeting were Regional Manager (RM) Stephenie Doub, Licensing Program Manager (LPM) Liza King, Licensing Program Analyst (LPA) Maja Jensen, LPA Christina Valerio, Gereral Auditor (GM) Jorge Mojica, and Licensee/Administrator Justice Ehimaiegho.
Topics of Discussion:
  1. Solvency Audit Report Findings - Based on information received and reviewed, it appears licensee has not established or maintained a financial plan
    • Operating Income: Facility’s operations generated a net profit, during the sampled month. However, reported food costs were below USDA guidelines and must be increased.
        • Reported Food Cost is $2,800 and USDA suggested Food Cost for 14 Residents is $3,437.00.
    • Cash Reserves: Licensee does not maintain sufficient cash reserves to ensure provision of care and supervision to residents. Recommended amount is to equal the monthly operating cost.
  2. Trust Audit Report Findings -
    • Improvement is needed in licensee's procedures when handling and safeguarding of resident monies.
      • Staff is handling resident’s monies but did not notify regional office or obtain a Surety Bond.
      • Licensee safeguards some residents’ debit cards but did not notify the regional office or obtain requisite Surety Bond. In addition, affected persons did not know (or did not recall) that facility staff safeguarded their debit cards.
      • Licensee should make reasonable efforts to safeguard resident property, including implementing a theft and loss program.
Continues on LIC 809 - C...
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 342700903
VISIT DATE: 10/25/2023
NARRATIVE
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Continued from LIC 809
2. Trust Audit Report Findings Continued -
    • Licensee did not provided requested items to auditor, even after multiple requests.

Licensee will do the following:
  • Licensee to provide to Audits Section by January 22, 2024: A balance sheet (LIC 403 or equivalent) reflecting all assets and liabilities, as of December 31,2023, an income statement (LIC 401 or equivalent) for the months of October 2023, November 2023, and December 2023 summarizing all income and expenses, and month end bank statements for all operating and savings accounts used for licensed facility for period of October 1, 2023, thru December 31, 2023.
    • Other information and documentation to be requested, as needed.
  • Licensee to provide to Audits Section by the 3rd week following each quarterly visit, provide to Audits Section an, income statement (LIC 401 or equivalent) with support, for the last month in the quarter and Bank statements (savings and checking accounts) and Utility vendor’s billings for each month of the previous quarter.
  • Licensee to provide the Regional Office a statement regarding Licensee Business Cash Reserves by November 27th, 2023
  • Licensee to submit a statement whether they will or will not change their plan of operation regarding handling/safeguarding resident monies by November 11th, 2023
  • Licensee to submit a copy of in-service training provided to staff regarding Bonding, Safeguard for Resident Cash, Personal Property, and Valuables, and Theft and Loss by November 11th, 2023


The Regional Office will do the following:
  • Continue Quarterly Financial Monitoring for a period of 1 year (to October 31, 2024)
    • RO to determine quarterly status after two quarterly periods
  • Continue to collaborate with Licensee as needed


Per California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, deficiencies are being cited on today's visit. Technical Advisory was provided for Title 22, Section 8755, General Food Service Requirements. An exit interview was held, and a copy of the report was provided via e-mail. Licensee to review, sign, and return signed copy to LPA by COB 10/272023.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/25/2023 05:24 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 342700903

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/27/2023
Section Cited
CCR
87213

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87213 Finances The licensee shall have a financial plan that conforms to the requirements of Section 87155... and that assures sufficient resources to meet operating costs for care of residents... This requirement was not met as evidenced by:
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Licensee stated he will submit a financial plan to ensure facilty reserves can be increased to the required amount. Financial Plan shall be submitted by POC due date
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Based on audit report findings, the licensee did not maintain sufficient cash reserves to ensure providision of care and supervision to residents in care.
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Type B
11/03/2023
Section Cited
CCR87216(a)

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87216 Bonding(a) Each licensee, other than a county, who is entrusted to safeguard resident cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal... This requirement was not met as evidenced by:
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Licensee stated training will be provided to administrator and staff regarding not handling residents' monies. Licensee to send proof of training by POC due date.
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Based on audit report findings, the licensee did not ensure 3 residents' monies were not handled by staff and when done so licensee did not obtain Surety Bond, which poses a potential health, safety, and personal rights risk to residents in care.
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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: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/25/2023 05:24 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 342700903

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2023
Section Cited
CCR
87217(a)

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87217 Safeguards for Resident Cash, Personal Property, and Valuables (a)...if a resident incapable of handling his own cash resources...cash resource shall be safeguarded in accordance with the regulations in this section. This requirement was not met as evidenced by:
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Licensee stated training will be provided to administrator and staff regarding Safeguards for Resident Cash, Personal Property, and Valuables. Proof of training will be provided by POC due date.
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Based on audit findings, the licensee did not ensure to make reasonable efforts to safeguard resident property, which poses a potential health, safety, and personal rights risk to residents in care.
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Type B
11/03/2023
Section Cited
CCR87218(a)

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87218 Theft and Loss (a) The licensee shall ensure an adequate theft and loss program as specified in Health and Safety Code Section 1569.153. This requirement was not met as evidenced by:
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 Licensee stated training will be provided to administrator and staff regarding the facility's Theft and Loss Program. Proof of training will be provided by POC due date.
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Based on audit report findings, the licensee did not ensure to have a theft and loss program in plan, which poses a potential health, safety, and personal rights risk to residents in care.
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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: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/25/2023 05:24 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CARE
FACILITY NUMBER: 342700903

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2023
Section Cited
CCR
87405(b)

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87405 Administrator - Qualifications and Duties (b) The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. This requirement was not met as evidenced by:
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Licensee stated administrator will complete required training, continue to collaborate with the Regional Office, and submit all necessary documentation to audits and the RO by POC due date.
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Based on audit report findings, the licensee did not ensure administrator followed their policies of the facility, which poses a potential health, safety, and personal rights risk to residents in care.
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Type B
11/03/2023
Section Cited
CCR87755(b)

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87755 Inspection Authority of the Licensing Agency (b) The licensee shall ensure that provisions are made for private interviews with any resident or any staff member; and for the examination of all records relating to the operation of the facility. This requirement was not met as evidenced by:
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Licensee stated administrator missed the e-mails and apologized for the oversight. Licensee to review regulations 87755 and submit a statement acknowledging understanding. Statement due to the RO by POC due date.
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Based on audit report findings, the licensee did not respond to Auditor's request for documentation, which poses a potential health, safety, and personal rights risk to resident in care.
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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: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2023
LIC809 (FAS) - (06/04)
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