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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700420
Report Date: 05/30/2025
Date Signed: 05/30/2025 01:08:07 PM

Document Has Been Signed on 05/30/2025 01:08 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:SOCAL CAREFACILITY NUMBER:
304700420
ADMINISTRATOR/
DIRECTOR:
HEENA KUMARFACILITY TYPE:
300
ADDRESS:17332 IRVINE BLVD. STE 284TELEPHONE:
7145191737
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: CENSUS: DATE:
05/30/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Vibhu Arya, designeeTIME VISIT/
INSPECTION COMPLETED:
01:30 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 visit. The EA met with the designee, Vibhu Arya. The licensee, Heena Kumar arrived shortly after. The EA observed the posting of the license and operating business hours. Business operating hours are from 9:00 am -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, Heena Kumar, and designee, Vibhu Arya via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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