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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201331
Report Date: 08/15/2024
Date Signed: 08/15/2024 03:48:58 PM


Document Has Been Signed on 08/15/2024 03:48 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:HOUSE OF PSALMS ASSISTED LIVING FOR SENIORSFACILITY NUMBER:
019201331
ADMINISTRATOR:OGUNDELE, BAMIKOLEFACILITY TYPE:
740
ADDRESS:1525 7TH AVETELEPHONE:
(925) 208-9250
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY:23CENSUS: 2DATE:
08/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Bamikole Ogundele, AdministratorTIME COMPLETED:
04:00 PM
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LPA Greg Clark conducted a face to face Component III presentation on 8/15/24 starting at 3:00 p.m. LPA met with licensee and administrator, Bamikole Ogundele.

LPA presented Component III power point and discussed the regulations embodied in the power point. LPA observed the participant gained knowledge about running and maintaining the facility in accordance with regulations.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory ClarkTELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2024
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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