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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 274700016
Report Date: 05/26/2026
Date Signed: 05/26/2026 01:00:38 PM

Document Has Been Signed on 05/26/2026 01:00 PM - 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:CENTRAL COAST SENIOR SERVICES, INC.FACILITY NUMBER:
274700016
ADMINISTRATOR/
DIRECTOR:		O'BRIEN, JOHNFACILITY TYPE:
300
ADDRESS:203 CALLE DEL OAKS, STE BTELEPHONE:
(831) 649-3363
CITY:DEL REY OAKSSTATE: CAZIP CODE:
93940
CAPACITY: CENSUS: DATE:
05/26/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:John O'BrienTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Enforcement Analyst (EA) Ruben Perez conducted a virtual visit and met with the licensee John O'Brien. During the visit, EA verified the posting of the license, observed the operation of the business, confirmed compliance with insurance requirements, reviewed payroll documentation and completed the required personnel file review. All requested documentation was provided and reviewed.

The Home Care Organization (HCO) was found to be in compliance with applicable Health and Safety Code requirements. No deficiencies were cited. An exit interview was conducted, and copies of 809 Facility Evaluation, 859 Staff Records Review Report, and appeal rights information were provided via email.

NAME OF LICENSING PROGRAM ANALYST: Ruben Perez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2026
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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