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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601102
Report Date: 04/23/2026
Date Signed: 04/23/2026 05:25:03 PM

Document Has Been Signed on 04/23/2026 05:25 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:S.T.A.R., INC.FACILITY NUMBER:
198601102
ADMINISTRATOR/
DIRECTOR:		BRODERICK, PAMELAFACILITY TYPE:
735
ADDRESS:4226 WEST 231ST STREETTELEPHONE:
(310) 791-3333
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY: 6CENSUS: 6DATE:
04/23/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:24 PM
MET WITH:Shannon HamlingTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 04/23/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit to the facility listed above. LPA met with Administrator, Shannon Hamling, and the purpose of today’s visit was explained. LPA was granted entry into the facility.
The facility is licensed to serve six (6) ambulatory, developmentally disabled adults, ages 18-59. Currently there are five (5) clients residing in the facility.
Physical Plant/Structure The facility is a single-story home in a residential neighborhood. The facility has six (6) bedrooms, staff room, office area, kitchen, living room, laundry room, and an attached garage. The backyard has a large table and chairs with an umbrella for client use. All walkways around the home were observed clean, clear, and free of obstructions, hazards, and debris. LPA did not observe any bodies of water on the premises.
Bedrooms LPA inspected all client bedrooms. LPA observed all rooms have the required furniture, including a bed, dresser, nightstand, chair, and storage space for personal belongings. LPA observed all beds have the required linens, including a mattress cover, fitted sheet, flat sheet, blankets, comforter, and pillows. LPA observed an ample supply of linens stored in cabinets in the hallways. All beds and bedding supplies were observed in good repair. LPA observed all bedrooms have ample lighting. LPA observed games and activities in client’s closets.
Bathrooms LPA inspected all bathrooms and observed them to be operational and within Title 22 regulations. All showers were observed clean and free of mold and/or mildew. All showers have non-slip mats. LPA observed an ample supply of toiletries for clients and clients’ toiletry buckets. LPA observed the bathrooms have secured safety handrails. The water temperature measured 110.9-degrees, 112.9-degrees and 113.3-degrees Fahrenheit.
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: S.T.A.R., INC.
FACILITY NUMBER: 198601102
VISIT DATE: 04/23/2026
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Kitchen LPA inspected the kitchen and found it to be clean and sanitary. All appliances were observed operational and in good repair. LPA observed an ample supply of cookware, dishware, and cutlery. LPA observed a 3-day supply of perishable foods, and a 7-day supply of nonperishable foods properly stored, packaged, and labeled. An additional supply of food and an emergency supply of food and water are stored in the garage. LPA observed knives and sharps secured in a locked drawer and are inaccessible to clients. LPA observed cleaning supplies secured in a locked cabinet under the kitchen sink and are inaccessible to clients. The water temperature measured 113.9-degrees Fahrenheit.
Common Rooms In the living room, LPA observed two (2) couches and a chair available for client use. LPA observed movies, games, and activities available for clients. LPA observed the dining room has a large table with chairs to accommodate all clients. The facility was observed appropriately furnished during the time of visit. All walkways and hallways inside the facility were observed clean, clear, and free of obstructions and hazards. The facility was maintained at a comfortable temperature during the time of visit.
File Review LPA observed client files secured in a locked cabinet in the staff office area. LPA reviewed the files for six (6) clients and observed they have the required documents. LPA reviewed six (6) clients P & I and found the documentation of expenditure to be consistent with receipts and amount available. LPA reviewed the Surety Bond valid till 10/21/2026. LPA observed staff files secured in a locked cabinet in the staff office area. LPA reviewed the files for the Executive Director, Administrator, and two (2) Direct Support Professionals (DSP), all files were observed with the required documents, certification, clearance, and training. The administrator’s Administrator Certificate 6070115735 is valid till 12/02/2026. LPA observed Licensing Fees are current.
Medications LPA observed Centrally Stored Medications secured in a locked cabinet in the staff office area. LPA observed Centrally Stored Medications in their original packaging. LPA reviewed the medication and the medication administration record (MAR) for six (6) clients. LPA observed that six (6) out of six (6) clients’ medications are consistent with proper documentation.
Safety LPA observed all smoke/carbon monoxide detectors are operable. LPA observed three (3) fully charged fire extinguisher lasted serviced on 02/18/2025. The last emergency drill was conducted on 02/04/26. The last Fire Prevention Inspection visit from the Torrance Fire Department was conducted on 09/23/2025. LPA reviewed the facility Emergency Disaster Plan (LIC610-D) that was last updated on 01/05/2026. LPA observed all required licensing postings throughout the facility. The facility has a working landline telephone. LPA inspected the First Aid kit and found it was fully stocked and had the required items including the manual. LPA received and reviewed the liability insurance through Acord that is valid till
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: S.T.A.R., INC.
FACILITY NUMBER: 198601102
VISIT DATE: 04/23/2026
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01/03/2027. There are no security bars over the windows. No firearms or ammunition are stored on the premises.
Infection Control During the tour, LPA observed the facility’s infection control practices. LPA observed a sanitizing station at the facility entrance with a visitor’s log, thermometer, and masks available. Sufficient paper, cleaning, and disinfecting supplies were observed. LPA observed required infection control postings throughout the facility.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe or cite any deficiencies during today’s visit.

An exit interview was conducted with Administrator, Shannon Hamling and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Wendy Gibbs
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
LIC809 (FAS) - (06/04)
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