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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700370
Report Date: 12/12/2025
Date Signed: 12/12/2025 11:51:22 AM

Document Has Been Signed on 12/12/2025 11:51 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:COASTAL HOME CAREFACILITY NUMBER:
304700370
ADMINISTRATOR/
DIRECTOR:		ALI, AHMADFACILITY TYPE:
300
ADDRESS:13341 ETON PLTELEPHONE:
(949) 357-7633
CITY:N TUSTINSTATE: CAZIP CODE:
92705
CAPACITY: CENSUS: DATE:
12/12/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Ahmad Ali, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB), conducted an on-site inspection for the purpose of a post licensing inspection. The EA met with the licensee, Ahmad Ali. EA observed the posting of the license and operating business hours. Business operating hours are from 7:00am am -9:00 pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee. Licensee stated they currently do not have homecare aids and clients at this time.

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, was provided to the licensee, Ahmad Ali via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2025
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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