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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603416
Report Date: 07/26/2024
Date Signed: 07/26/2024 11:42:49 AM


Document Has Been Signed on 07/26/2024 11:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:MORNINGSTAR OF PASADENAFACILITY NUMBER:
198603416
ADMINISTRATOR:TALIAFERRO, KEVINFACILITY TYPE:
740
ADDRESS:951 S. FAIR OAKS AVENUETELEPHONE:
(626) 204-1700
CITY:PASADENASTATE: CAZIP CODE:
91105
CAPACITY:310CENSUS: 151DATE:
07/26/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator kevin Taliaferro, Representatives- Steve Martin, Cad James, Melissa ClementTIME COMPLETED:
11:30 AM
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An Informal Conference meeting was held at the Monterey Park Adult and Senior Care Regional Office. Present during this meeting were Licensing Program Manager (LPM) Fernando Fierros, Licensing Program Analyst (LPA) Sanjay Vaid, and from Morning Star were Administrator Kevin Taliaferro, and Authorized Representatives Steve Martin, Chad James and Melissa Clement..

The following items listed below were discussed during today's meeting:
  • Complaint investigation findings for complaint # 28-AS-20230503110725
  • Section 87468.2 - Facility did not have sufficient staff to meet residents needs
  • Section 87468.2 Facility is not providing reasonable accommodations to residents in care
  • Section 87415 - Night supervision- Emergency personnel could not access facility
  • Section 87303 - Facility in Disrepair
  • Section 87211- Facility did not report COVID-19 outbreak to the department per Title 22 Regulations.


The following Title 22 topics were discussed and a copy of the Section given during office meeting:
  • Night Supervision, Section 87415
  • Additional Personal Rights of Residents in Privately Operated Facilities, Section 87468.2
  • Infection Control Requirements, Section 87470
  • Reporting Requirements, Section 87211
  • Maintenance and Operations, Section 87303

Annual Licensing Fees in the amount of $3300.00 are due by 09/23/2024. Fees will paid prior to the due dates. A copy of the licensing fees were provided during office meeting.

Administrator Taliaferro, stated the plan of corrections that were implemented to ensure the safety of the facility and of the residents.

A plan to utilize the parking lot for construction purposes will be provided to the department.

An exit interview was conducted and a copy of the report was provided to the Administrator Kevin Taliaferro.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay VaidTELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2024
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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