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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623100
Report Date: 08/04/2022
Date Signed: 08/04/2022 09:56:26 AM

Document Has Been Signed on 08/04/2022 09:56 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:EKEKWE, ELSHEBIAFACILITY NUMBER:
343623100
ADMINISTRATOR:EKEKWE, ELSHEBIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 517-8410
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Elshebia EkekweTIME COMPLETED:
10:00 AM
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On 8/4/2022 at 9:00 AM, Licensing Program Analysts (LPAs) Amanda Sutter and Arianna Manabat arrived at the home of Elshebia Ekekwe for the purpose of an unannounced case management inspection. LPAs are investigating a complaint related to another provider. Upon arrival, LPAs observed 12 children supervised by 2 staff. All individuals subject to criminal background review have obtained a criminal record clearance.

A notice of site visit was given and must remain posted for 30 days. Based on the inspection, no citations have been issued. Exit interview conducted and report was reviewed with the licensee Elshebia Ekekwe.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2022
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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