374603625-7-18-2025-08-AS-SJAB-DK4VGH-20250731162534

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603625
Report Date: 07/18/2025
Date Signed: 07/18/2025 05:21:35 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
06/23/2025 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20250623125909

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:	150	CENSUS: 94	DATE:	07/18/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Executive Director Brandon Cho		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff do not communicate with responsible party regarding resident's care.
Staff are not properly supervising a resident who is a fall risk.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced complaint visit to further invisitage and delivered findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Executive Director Brandon Cho and stated the purpose of the visit.

On June 23, 2025, it was alleged that Staff did not communicate with responsible party regarding resident's care. More specifically, Licensee staff will not communicate with Resident #1(R1) medical power of attorney(POA) when they ask for information about R1 over the phone. A review of facility records and Interviews with R1's responsible party reveal that communication between the facility staff and the responsible party, who is also the POA, occurs frequently. R1's responsible party stated they have no concerns regarding communication with the staff. Based on the information obtained, the facility appears to be following appropriate protocol by limiting the disclosure of personal health information to only those authorized. (Continued on LIC9099)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

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-20250623125909

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: 07/18/2025

NARRATIVE

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(CONTINUED FROM LIC9099)

It was also alleged Licensee staff are not properly supervising R1 who is a fall risk. More specifically, R1 falls often and R1 requires assistance for all her tasks. A review of R1's physicians reported dated June 23, 2025 reveals a diagnosis of senile degeneration of the brain and is currently also under the care of a hospice agency.

LPA observations reveal staff assist residents during ambulation, monitor common areas, and provide one-on-one support for those residents that may be a fall risk. LPA also reviewed staff files and they revealed extensive precautionary fall prevention training. Staff interviews confirmed they were knowledgeable about resident's needs and trained in fall prevention protocols. Additional outside source interviews reflected a sense of safety and satisfaction with the level of care supervision provided. A review of incident reports showed timely follow-ups for R1, and care documentation for R1 revealed updated care plans.

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 Brandon Cho,Executive Director. A copy of this report was provided and their signature on this report confirms receipt.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

LIC9099 (FAS) - (06/04)

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