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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 12:25:22 PM

Document Has Been Signed on 01/02/2025 12:25 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
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: 0DATE:
01/02/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH: Cheryl Hodges- House ManagerTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On 1/02/2025 at approximately 09:40 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. Upon arrival LPA rang the doorbell and knocked on the door to no response. LPA then phoned the Administrator Marlon King and left a voicemail stating the reason for today’s visit. House Manager, Cheryl Hodges, returned LPA’s phone call and arrived shortly after to assist with today’s visit.

LPA asked for census, staff, and client files. House Manager Hodges informed LPA that the facility is still awaiting clients. There are zero (0) clients currently. LPA conducted a physical plant tour at approximately 11:30 AM and the following was noted:

There is only one entrance being utilized at the facility. The facility is a two-story building with four (4) bedrooms and three (3) bathrooms currently occupying zero (0) clients. The facility is fire cleared for four (4) ambulatory clients.

Required postings such as Emergency Disaster Plan, Facility License, See Something Say Something, and Personal Rights were located at the main entrance. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available.

Common areas observed to be neat, clean, and organized. Living room observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 66°F. Fire extinguisher located in the living room and dated 06/24/24. Fireplace observed to be covered inaccessible to clients. Working telephone observed in living room.

Staff reception desk observed in living room with locked filing cabinet that will contain client and staff records. (continued on LIC 809-C)

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)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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
VISIT DATE: 01/02/2025
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The kitchen observed to be fully stocked with two (2) days perishable and seven (7) days non-perishable food. Kitchen observed to be clean and inaccessible to pests. Knives and sharps observed to be locked in locked box in kitchen cabinet inaccessible to clients. Kitchen appliances observed to be working and in proper condition.

The backyard of the facility is equipped with a designated shaded area with outdoor furniture for clients. There is no body of water in this facility.

Smoke detectors and carbon monoxide observed to be working properly and were tested.

The laundry room is located near the kitchen leading towards the garage. Laundry detergents, cleaning agents, and other toxins are stored in a locked cabinet in the laundry area inaccessible to clients.

The Garage can be accessed from inside the facility. The garage is kept locked. It is being utilized for extra storage.

The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations at 119.1°F. Towels and washcloths will not be shared. Sufficient availability of clean lien and extra towels are stored in upstairs hallway cabinets.

Medications: Medication will be kept in kitchen cabinet near the refrigerator locked and inaccessible to clients. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer, and manual.

Client records: No clients at this time.



There was no health and safety hazard observed during the day of inspection.

Exit interview conducted and a copy of this report was given.

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
LIC809 (FAS) - (06/04)
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