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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405802273
Report Date: 08/04/2023
Date Signed: 09/14/2023 04:18:46 PM

Document Has Been Signed on 09/14/2023 04:18 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:STARLING HOMEFACILITY NUMBER:
405802273
ADMINISTRATOR:DEBORAH STARLINGFACILITY TYPE:
735
ADDRESS:872 SYCAMORE CANYON RDTELEPHONE:
(805) 237-7307
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 6CENSUS: 5DATE:
08/04/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Administrator / Deborah StarlingTIME COMPLETED:
10:58 AM
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 However, this is the third documented report to Community Care Licensing Division (CCLD) of staff from this facility speaking inappropriately to clients, all three different independent sources from two different program facilities documenting and reporting to CCLD of facility staff inappropriately talking to facility clients. Though this investigation pertaining to this complaint’s specific allegation on 06/05/2023 was not substantiated at this time based on the evidence from 06/05/2023 incident reports and interviews conducted. This being the third independent source reporting the same type of allegation (29-AS-20221101162949 and Incident report on 05/05/2023), a technical violation (TV) will be issued based on the third report of the same type of incident, staff speaking inappropriately to clients. A technical violation is issued at this time.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2023
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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