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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700470
Report Date: 10/28/2025
Date Signed: 10/28/2025 10:03:44 AM

Document Has Been Signed on 10/28/2025 10:03 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:REY HOME CAREFACILITY NUMBER:
304700470
ADMINISTRATOR/
DIRECTOR:		GHOLAM RANJBARFACILITY TYPE:
300
ADDRESS:395 SAN LEONTELEPHONE:
(949) 594-6639
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY: CENSUS: DATE:
10/28/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Gholam Ranjbar, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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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, Gholam Ranjbar. EA observed the posting of the license and operating business hours. Business operating hours are from 9:00 am -5:00 pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for the licensee. According to the licensee, they currently do not have clients and Home Care Aides. The Home Care Organization’s (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) was provided to licensee, Gholam Ranjibar via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2025
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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