374603625-10-3-2024-08-AS-SJAB-D9XV96-20241011161349

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603625
Report Date: 10/03/2024
Date Signed: 10/03/2024 06:10:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/02/2024 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20241002140953

FACILITY NAME:	STELLAR CARE		FACILITY NUMBER:	374603625
ADMINISTRATOR:	BRANDON CHO		FACILITY TYPE:	740
ADDRESS:	4518 54TH STREET		TELEPHONE:	(619) 287-2920
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	120	CENSUS: 103	DATE:	10/03/2024
		UNANNOUNCED	TIME BEGAN:	12:21 PM
MET WITH:	Administrator Brandon Cho		TIME COMPLETED:	01:10 PM

ALLEGATION(S):

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Staff do not ensure that residents' dietary needs are met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced complaint visit to the facility to open a complaint on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Administrator Brandon Cho to discuss the purpose of the visit.

LPA conducted the investigation visit and was able to interview facility staff, and outside sources. LPA also reviewed records and conducted a physical inspection of the facility which included the kitchen as well as meal service. It was alleged that the licensee does not ensure that residents' dietary needs are met.

Records review revealed 31 of 103 residents have a special need and/or preferred diets and the licensee is able to accommodate the special needs diets as well as the preferred diets. Record reviews indicate the last consultant dietitian report was dated 7/17/24 and no concerns were noted.
(Continued on 1099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20241002140953

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: STELLAR CARE	FACILITY NUMBER: 374603625
	VISIT DATE: 10/03/2024

NARRATIVE

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(Continued from 1099)

Interviews with staff revealed the clients eat a variety of fruits and vegetables along with grains, yogurt and meats. Observations revealed the facility has an updated menu that is completed and is renewed every week, and the staff adhere to the facility menu for the clients. LPA observations revealed meals being prepared and served to residents. LPA observation during meal service revealed a full dining room and the clients were eating green salad, roast beef with gravy, vegetables, bread and peach cobbler.

Interviews with an outside source revealed they have not had any issues with the facility or with the meals/foods being served. Interviews with staff also revealed that some clients eat different meals depending on their preferences or dietary restrictions.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Administrator Cho, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

LIC9099 (FAS) - (06/04)

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