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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 384700016
Report Date: 02/11/2025
Date Signed: 02/11/2025 12:07:05 PM

Document Has Been Signed on 02/11/2025 12:07 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 CALIFORNIA, LLCFACILITY NUMBER:
384700016
ADMINISTRATOR/
DIRECTOR:
CHEN XIEFACILITY TYPE:
300
ADDRESS:2001 JUNIPER SERRA BLVD #520TELEPHONE:
(650) 208-2390
CITY:DALY CITYSTATE: CAZIP CODE:
94014
CAPACITY: CENSUS: DATE:
02/11/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Designee - Maritess NicolasTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of The Key of California, LLC for a Two-Year Licensing inspection on February 11, 2025. Upon arrival, the Analyst identified himself and was greeted by designee Maritess Nicolas. The proper posting of business hours and license was observed. The Analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the Analyst discussed the findings of the inspection with the designee and informed the designee that no discrepancies were found. A copy of the report was provided with appeal rights. Exit interview was conducted.
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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