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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700095
Report Date: 05/19/2026
Date Signed: 05/21/2026 07:39:02 AM

Document Has Been Signed on 05/21/2026 07:39 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:4EVER YOUNG LIVING LLCFACILITY NUMBER:
304700095
ADMINISTRATOR/
DIRECTOR:		KHETARPAL, REEMAFACILITY TYPE:
300
ADDRESS:3918 EAST COAST HIGHWAYTELEPHONE:
(949) 514-4635
CITY:CORONA DEL MARSTATE: CAZIP CODE:
92625
CAPACITY: CENSUS: DATE:
05/19/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Reema Khetarpal, LicenseeTIME VISIT/
INSPECTION COMPLETED:
08:15 AM
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Home Care Services Branch (HCSB), Enforcement Analyst (EA), Mila Quinto spoke to licensee Reema Khetaarpal to conduct a telephone pre-inspection interview. The licensee is due for a biennial visit and has agreed to a virtual visit with EA. The virtual visit is scheduled for May 28, 2026 at 11:00 am via Microsoft Teams/FaceTime.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2026
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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