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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 419210056
Report Date: 09/25/2024
Date Signed: 09/25/2024 11:47:42 AM

Document Has Been Signed on 09/25/2024 11:47 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:DIVINE HOPE RESIDENTIAL FACILITYFACILITY NUMBER:
419210056
ADMINISTRATOR/
DIRECTOR:		OSCAR OYEMA OMORAGBONFACILITY TYPE:
735
ADDRESS:125 HEMLOCK AVENUETELEPHONE:
(650) 599-0349
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 4CENSUS: 3DATE:
09/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Victor Ogieriakhi, Facility ManagerTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On September 25, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct an unnanounced Case Management visit in regards to unpaid Annual fees. LPA Calandra was greeted by Victor Ogieriakhi, Facility Manager and explained the purpose of the visit.

In the presence of the LPA, Victor Ogieriakhi, Facility Manager stated he would pay the Annual fee.

No deficiencies were cited during today's visit.

An exit interview was conducted and this report was reviewed with Victor Ogieriakhi, Facility Manager. A copy of the report was left at the facility.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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