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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200981
Report Date: 12/05/2024
Date Signed: 12/05/2024 01:59:22 PM

Document Has Been Signed on 12/05/2024 01:59 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, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:ST JOHN CORINTHIAN CARE, LLCFACILITY NUMBER:
019200981
ADMINISTRATOR/
DIRECTOR:		HODGE, MARCIEFACILITY TYPE:
772
ADDRESS:1000- 102TH STREETTELEPHONE:
(510) 325-8723
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY: 6CENSUS: 0DATE:
12/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Marcie Hodge, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 12/5/24 at 1:15 p.m., Licensing Program Analyst (LPA) Greg Clark arrived to conduct 1-Year Annual Required inspection. LPA met with Administrator, Marcie Hodge, Administrator and explained the purpose of the visit. There are currently no residents living at the facility.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 110.5 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients.

Smoke detectors, fire extinguisher and carbon monoxide were in operating condition during visit.

LPA reviewed 1 staff record, and it was complete.

No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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