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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194701117
Report Date: 07/15/2026
Date Signed: 07/15/2026 11:01:02 AM

Document Has Been Signed on 07/15/2026 11:01 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:AMADA SENIOR CARE CARSON CAFACILITY NUMBER:
194701117
ADMINISTRATOR/
DIRECTOR:		YANAN GUOFACILITY TYPE:
300
ADDRESS:500 E. CARSON PLAZA STE 106TELEPHONE:
(310) 295-0698
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: CENSUS: DATE:
07/15/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:BAILEY YANG - LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Home Care Services Branch (HCSB), Enforcement Analyst (EA), Jane Cong-Huyen spoke to licensee, Bailey Yang, to conduct a telephone pre-inspection interview. Licensee confirmed HCO Information. The HCO is due for a biennial visit and has agreed to a virtual inspection visit with EA.

The virtual inspection visit is scheduled for Wednesday 7/22/2026 @ 2:30pm via Microsoft Teams. EA emailed the HCO with specific instructions regarding the virtual licensing inspection and the required documentation for the HCO to submit to EA via email before/by Monday 7/20/26.

The HCO will be receiving this report via email. HCO will send report back to EA with signature as soon as possible or by today 7/15/26 to confirm the virtual inspection visit with payroll records from the last 30 days.

NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
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