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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700340
Report Date: 06/05/2025
Date Signed: 06/05/2025 11:03:45 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/05/2025 11:03 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:ASSISTING HANDS YORBA LINDAFACILITY NUMBER:
304700340
ADMINISTRATOR/
DIRECTOR:		KOH, SHANAFACILITY TYPE:
300
ADDRESS:377 E. CHAPMAN AVE. SUITE 205TELEPHONE:
9493755029
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY: CENSUS: DATE:
06/05/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Shana Koh, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Enforcement Analysts (EAs), Mila Quinto, with the Home Care Services Branch (HCSB) conducted an on-site inspection for the purpose of a post licensing visit. The EA met with the licensee, Shana Koh. The EA observed the posting of the license and operating business hours. Business operating hours are from 9:00am -5:00pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status', registry status', Tuberculosis (TB), and required training. The HCO’s business records were also reviewed during the visit including, the insurance requirements.

During today’s visit, EA Quinto found the HCO was in compliance and no deficiencies were cited.

An exit interview was conducted, a copy of this report (HCS809), staff records review (HCS 859) and appeal rights were provided to the licensee, Shana Koh via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2025
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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