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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500599
Report Date: 06/21/2022
Date Signed: 06/21/2022 11:22:28 AM

Document Has Been Signed on 06/21/2022 11:22 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:KEMOKAI, RASHIDIFACILITY NUMBER:
344500599
ADMINISTRATOR:KEMOKAI, RASHIDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 513-9610
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/21/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rashidi KemokaiTIME COMPLETED:
11:30 PM
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On 06/21/2022, Licensing Program Analyst (LPA) Katy Maestas met with Applicant Rashidi Kemokai (A1) for the purpose of a second prelicensing inspection. Upon arrival, LPA disclosed the purpose of the inspection and was granted entrance into the FCCH. A1 was the only adult present in the home with her two children and a friend's child. All individuals subject to criminal background review have obtained a criminal record clearance verified by LPA accessing Guardian.

A health and safety inspection was conducted inside and outside of the home. A1 accompanied LPA for the entirety of the tour. The FCCH contains three levels: lower level, first level and upper level. The lower level of the home has a living room, bathroom, bedroom, laundry room and access to the garage. The stairs between the lower level and the first level have been barricaded with a baby gate that is affixed to two side boards which have been screwed into the wall and banister of the home. LPA suggested to A1 that children are kept clear of this area even with the baby gate present. The first floor of the home has a kitchen, dining room and a play room. The upper level of the home has a master bedroom and bathroom, 2 bedrooms, and a bathroom. The off-limits areas in the home are the upper level, garage, laundry room, and side yards. Off-limits areas will remain inaccessible to children. The outdoor play area was toured and no pool, spa or water feature was observed by LPA. The side yard (near the kitchen) was made inaccessible to children in care by affixing a large piece of board to the perimeter fence and house. The backyard has been cleaned of debris and small choking hazards. LPA inquired about the dog who was present in the backyard behind a low barricade. A1 stated that her dog will be kept inside the garage when children are in care.

As of today, 06/21/2022, Licensee is approved for a Large Family Child Care Home license; however, A1 has not submitted LIC 9149 to the Regional Office and therefore, may only serve a maximum capacity of 12 children with no more than 2 Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old OR a capacity of only 4 infants.


An exit interview was conducted and the report was reviewed with A1. Licensee Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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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