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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701329
Report Date: 11/30/2023
Date Signed: 11/30/2023 03:14:00 PM

Document Has Been Signed on 11/30/2023 03:14 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:CHIDIKE CARE HOME II LLCFACILITY NUMBER:
342701329
ADMINISTRATOR:OFODIRE, NNAEMEKAFACILITY TYPE:
735
ADDRESS:8252 ANTON WAYTELEPHONE:
(916) 478-1844
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 4CENSUS: 0DATE:
11/30/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Nnaemeka OfodireTIME COMPLETED:
03:40 PM
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On 11/30/23 at 1:30 pm, Licensing Program Analyst (LPA) Tung Truong arrived announced to conduct a Pre-Licensing Inspection of the facility to ensure compliance with Title 22 regulations. LPA met with Applicant, Nnaemeka Ofodire who assisted LPA in today’s inspection. Nnaemeka Ofodire holds current administrator certificate #: 6054572735 which will expire on 12/5/2023.

It was learned that this facility will be licensed to serve up to 4 ambulatory clients. There were no clients present during today's pre-licensing visit. LPA toured the facility with Nnaemeka Ofodire.

LPA observed the facility common areas were clean and furnished. LPA observed client rooms to have required furniture. The temperature inside the facility was observed to be at 72*F which is within the required range of 68-85*F. Hot water temperature was measured and is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility were up to date and in good repair. LPA observed the centrally stored medications area to be locked and inaccessible to clients. The first aid kit was up to date. LPA observed no obstruction of emergency exits inside or outside of facility.

Based on a review of this facility during this Pre-licensing visit, it was determined that this facility was found to be in compliance at this time. Applicant has completed Component III before and therefore, waive this requirement. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed.

Per the California Code of Regulations Title 22, no deficiencies were observed or cited.
Exit interview held, copy of report given.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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