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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700114
Report Date: 07/30/2024
Date Signed: 07/30/2024 02:42:18 PM

Document Has Been Signed on 07/30/2024 02:42 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:THEKEY OF CALIFORNIAFACILITY NUMBER:
304700114
ADMINISTRATOR/
DIRECTOR:		MELISSA REYESFACILITY TYPE:
300
ADDRESS:2 VENTURE, SUITE 515TELEPHONE:
(650) 208-2390
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: CENSUS: DATE:
07/30/2024
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Jessica Pascasio, DesigneeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Home Care Services Bureau (HCSB) Analyst, Mila Quinto arrived at the business office of The Key California for a biennial inspection. Upon arrival, Analyst Quinto was greeted by designee, Jessica Pascasio. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. The Analyst reviewed the personnel and administrative files. Based on the file review, analyst informed the designee there are no discrepancies found.

The analyst provided a copy of the report to the designee via email.

LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
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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