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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603625
Report Date: 05/11/2026
Date Signed: 05/11/2026 01:31:38 PM

Document Has Been Signed on 05/11/2026 01:31 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:STELLAR CAREFACILITY NUMBER:
374603625
ADMINISTRATOR/
DIRECTOR:		BRANDON CHOFACILITY TYPE:
740
ADDRESS:4518 54TH STREETTELEPHONE:
(619) 287-2920
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 150CENSUS: 112DATE:
05/11/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Assisted Living Director Annelie DamascoTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to cite deficiencies identified during a separate complaint investigation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Assisted Living Director Annelie Damasco.

During his 05/06/2026 visit, LPA observed that the lobby’s front door was locked from both the outside and from the inside. People could not leave the building unless the receptionist buzzed them out (i.e. unlocked the door for them). Delayed-egress doors are also in use at the facility. Neither Stellar Care’s existing CCLD-issued facility license nor latest prior-approved fire clearance document (STD850 dated 08/30/2019) granted approval for use of secured perimeter doors or delayed egress doors. As of the date of deficiency issuance, the facility’s application related to a change in ownership (to become Vista del Sol Assisted Living and Memory Care, 374605041) is with CCLD’s Centralized Applications Bureau (CAB). However, even Vista Del Sol’s latest approved fire clearance document (STD850 dated 12/10/2025) does not yet grant approval for use of secured perimeter doors or delayed egress doors.

Records and interviews showed: Resident #1 (R1) moved into the facility on 04/13/2026 and was subsequently hospitalized starting 04/29/2026. [See LIC811 Confidential Names List for a description of person identifiers used in this report.] However, Licensee did not conduct a care conference/meeting with R1’s responsible person (RP) and hospice agency personnel for the purpose of reviewing the “written record of the care the resident will receive in the facility, and the resident’s preferences regarding the services provided at the facility.” This was required to be completed no later than two (2) weeks after move-in (i.e., by 04/27/2026, at the latest). R1 was under the care of Suncrest Hospice from the time of move-in to the facility. However, as of the commencement of CCLD’s investigation on 05/06/2026, Licensee still had not arranged for R1’s hospice agency personnel to “provide training specific to the current and ongoing needs” of R1, as required. [CONTINUED ON LIC 809-C]

NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: STELLAR CARE
FACILITY NUMBER: 374603625
VISIT DATE: 05/11/2026
NARRATIVE
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[CONTINUED FROM LIC 809]

Four (4) deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC809-D pages). Plans of Correction were jointly developed with the Licensee. Since at least one of the deficiencies relates to a violation of the facility’s prior-approved fire clearance document, an immediate civil penalty of $500 was charged/assessed to Licensee (refer to the LIC421-IM page). LPA also provided Technical Assistance (TA) regarding the facility’s electronic Medication Administration Record (MAR) (refer to the LIC9102-TA page).

An exit interview was conducted with Assisted Living Director Annelie Damasco, to whom a copy of this report, the LIC 809-D pages, the LIC421-IM page, the LIC9102-TA page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 05/11/2026 01:31 PM - It Cannot Be Edited


Created By: Dang Nguyen On 05/11/2026 at 11:45 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: STELLAR CARE
FACILITY NUMBER: 374603625

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/11/2026
Section Cited
CCR
87705(f)(2)

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87705 Care of Persons with Dementia: “(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, License has deactivated the described secured perimeter door. The facility is in the process of being sold/transferred. The buyer’s application for a facility license is in process/pending with CCLD’s Centralized Applications Bureau (CAB), but their latest STD850 fire clearance does not yet specify approval for secured perimeter doors. Licensee has since instructed Windandsea, LLC to contact CAB and fire inspector to ensure such written endorsement is added to both the STD850 and subsequent facility license for Vista del Sol Assisted Living and Memory Care (374605041). This action resolves the deficiency.
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Per LPA observation, records review, and manager interview, Licensee did not ensure that the facility’s latest fire clearance included approval for use of secured perimeter. This posed an immediate safety risk to 113 of 113 residents (R1 through Resident #113) in care.
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Type A
05/11/2026
Section Cited
CCR87705(e)(2)

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87705 Care of Persons with Dementia: “(e) Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: (2) The licensee shall ensure that the fire clearance includes approval of delayed egress devices.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, the facility is in the process of being sold/transferred. The buyer’s application for a facility license is in process/pending with CCLD’s Centralized Applications Bureau (CAB), but their latest STD850 fire clearance does not yet specify approval for delayed egress devices on doors. Licensee has since instructed Windandsea, LLC to contact CAB and fire inspector to ensure such written endorsement is added to both the STD850 and subsequent facility license for Vista del Sol Assisted Living and Memory Care (374605041). This action resolves the deficiency.
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Per LPA observation, records review, and manager interview, Licensee did not ensure that the facility’s latest fire clearance included approval use of delayed egress devices on doors. This posed an immediate safety risk to 113 of 113 residents (R1 through Resident #113) in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:
Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/11/2026 01:31 PM - It Cannot Be Edited


Created By: Dang Nguyen On 05/11/2026 at 11:51 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: STELLAR CARE
FACILITY NUMBER: 374603625

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/11/2026
Section Cited
CCR
87467(a)

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87467 Resident Participation in Decisionmaking: “(a) Prior to, or within two weeks of the resident’s admission, the licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff, and a representative of the resident’s home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will receive in the facility, and the resident’s preferences regarding the services provided at the facility.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, R1 has effectively moved out, so no further action is required for R1. Going forward, Licensee agreed to ensure that every resident’s record has thorough, documented proof of a care conference/meeting occurring prior to or within 2 weeks of move in, again at least every 12 months thereafter, and upon any “significant change in the resident’s condition.”
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Based on records review and manager interview, for 1 of 113 residents (R1), Licensee did not within two weeks of the resident’s admission hold a joint meeting with the resident’s representative, hospice agency personnel, and appropriate facility staff to prepare and approve the written record of care that the resident will receive at he facility, to include the resident’s preferences regarding services provided at the facility. This posed a potential health and personal rights risk to persons in care.
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Type B
05/11/2026
Section Cited
CCR87633(b)(6)(B)

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87633 Hospice Care of Terminally Ill Residents: “(b)(6)(B) The hospice agency will provide training specific to the current and ongoing needs of the individual resident receiving hospice care and that training must be completed before hospice care to the resident begins.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, R1 has effectively moved out, so no further action is required for R1. Going forward, for every hospice resident, Licensee agreed to ensure that their assigned hospice nurse case manager leads an in-service training for the facility’s direct care staff prior to move-in, and to maintain documented proof of such completion.
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Based on records review and manager interview, for 1 of 113 residents (R1), Licensee did not ensure that their hospice agency personnel provided training specific to the current and ongoing needs of the resident, prior to hospice care starting. This posed a potential health risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:
Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2026


LIC809 (FAS) - (06/04)
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