Community Care Licensing

FACILITY NAME:	BAY HOME CARE SERVICES LLC		FACILITY NUMBER:	434700105
ADMINISTRATOR:	ESMAEILI, KOUROSH		FACILITY TYPE:	300
ADDRESS:	1211 PARK AVE., STE. 214		TELEPHONE:	(408) 656-6849
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY:		CENSUS:	DATE:	09/20/2023
	Required - 2 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Tahmineh Esmaeili		TIME COMPLETED:	02:50 PM

NARRATIVE

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Home Care Services Bureau (HCSB) Associate Government Program Analyst (AGPA) Megan Vigil arrived at the business office of Bay Home Care Services LLC on 9.20.23 at approximately 1:50pm. Upon arrival, AGPA Vigil identified herself and was greeted by Licensee, Tahmineh Esmaeili. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. AGPA Vigil was 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 Licensee and no discrepancies were found.

LICENSING EVALUATOR NAME: Megan Vigil LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023