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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610310
Report Date: 01/02/2025
Date Signed: 01/02/2025 10:00:56 AM

Document Has Been Signed on 01/02/2025 10:00 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:HODGES HOMES INC.FACILITY NUMBER:
197610310
ADMINISTRATOR/
DIRECTOR:		KING, MARLONFACILITY TYPE:
735
ADDRESS:37137 CANNON CTTELEPHONE:
(661) 860-4425
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 4CENSUS: DATE:
01/02/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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On 1-2-2025 at approximately 9:40 AM, Licensing Program Analyst (LPA) Angelica Segovia attempted a re-attempt of an unannounced annual visit for the facility. Upon arrival LPA rang the door bell and knocked on the door to no response. LPA called Administrator Marlon King (661-860-4425) and left a voicemail. LPA will attempt to make required annual on a later date. No signature available.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
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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