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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850586
Report Date: 02/12/2026
Date Signed: 02/12/2026 12:14:21 PM

Document Has Been Signed on 02/12/2026 12:14 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ALL STAR LIVING INCFACILITY NUMBER:
195850586
ADMINISTRATOR/
DIRECTOR:		ALAJANYAN,SATENIKFACILITY TYPE:
740
ADDRESS:8123 PASO ROBLES AVETELEPHONE:
(818) 802-0866
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 6CENSUS: DATE:
02/12/2026
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:31 AM
MET WITH:Satenik Alajanyan, TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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An Informal Conference was conducted today in the Woodland Hills Adult and Senior Care Regional Office. The purpose of this Informal Conference is to discuss deficiencies cited during the period of 2025 and 2026 as well as concerns arising from case management deficiencies.

Present at today's meeting included the Licensee (All Star Living Inc.) Satenik Alajanyan, Yasir Amir, and Estelita Agpada, Licensing Program Manager (LPM) KaSandra Lopez and Licensing Program Analyst (LPA) Sandra Urena.



The informal conference process was explained to the Licensee. The Licensee was informed that this Informal Conference is a part of the administrative action process and that further citations may result in a Non-Compliance Conference, which could lead to a referral for Administrative Review by the Department’s Legal Division for possible Administrative Action.

Citations discussed related to:

Operating overcapacity and having 7 residents when only fire department cleared for 6 residents of which civil penalty was issued, a resident eloping which resulted in found wandering in the streets and picked up by LAFD, staff not having current CPR and medication training, residents not having pre-admission appraisals, two citations related to reporting requirements, staff administering unprescribed medications to resident, medication review that resulted in inconsistency on how medications are prescribed and the amount of medication remaining, cockroaches observed in kitchen and pantry, and facility telephone number not being available for family use. Continues on LIC 809C...

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Sandra Urena
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2026
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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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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ALL STAR LIVING INC
FACILITY NUMBER: 195850586
VISIT DATE: 02/12/2026
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Today, a Case Management report was also issued for deficiencies observed by the LPA on 01/27/2026. Those additional deficiencies include 87457 Pre-Admission Appraisal, 87608 (5)(B)-Postural Supports, 87303 (a)Maintenance and Operation 87555(b)(27), HSC 1569.69(b) Medication training, 87355(e)(1) Criminal Record Clearance.

Outstanding plan of corrections were also discussed, and the licensee has until Tuesday, February 17, 2026, to submit POCs for the 10/15/2025 Complaint and Case Management visits, and the 2/3/2026 Complaints visits.

The CCLD’s Technical Support Program (TSP) was explained to the Licensee. The Licensee was also provided the CCLD website information and was also provided paper copies of resource guides for Hospice Care, Medication Guide, and the Pressure Injuries Guide which can also be found on the CCLD’s website along with other resources, including a RCFE assessment guide so you can be prepared for your first annual inspection. The licensee explained that their plan of action to be in compliance with the department includes hiring a designated Administrator and consistent staff (caregivers).

The Licensee agreed to be referred to TSP.

Brief History: The facility was first licensed on 04/01/2025, for a capacity of six (6) residents.

The parties discussed deficiencies related to the following incidents and observations:

06/19/2025-Case Management Deficiency

· During interview with Staff #1 (S1) revealed that sometime early in June 2025 the exact date is unknown the facility was over capacity and had seven (7) residents. Cited for 87204 Limitations - Capacity and Ambulatory

Continues on LIC 809C...

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Sandra Urena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC809 (FAS) - (06/04)
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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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ALL STAR LIVING INC
FACILITY NUMBER: 195850586
VISIT DATE: 02/12/2026
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08/21/2025-Complaint #29-AS-20250821122539

· Lack of supervision resulting in resident eloping from the facility.

· Cited for 87464(f)(1) Basic Services.

08/25/2025-Case Management Deficiency

· Staff did not have CPR/First Aid Training.

· Cited for 87411(c)(1)(2) (c) Lack of training.

10/11/2025-Complaint C#29-AS-20251011205324

· Staff provided unprescribed medication to resident.

· Cited for 87465 (a)(2)- Incidental Medical and Dental Care

10/15/2025-Case Management-Defiency

· Licensee did not report to CCL about staff providing unprescribed medication to resident.

· Cited for 87211 Reporting Requirements (a) (1)(A-D)

01/27/2026- Complaint #29-AS-20260127125601

Allegations:

· Staff did not administer medication to a resident in care.

· Staff did not keep facility free of vermin.

· Cited for 87465(a)(4) and General Food Service Requirements (b)(27)

02/04/2026-Complaint #29-AS-20260204082332

· Facility staff are not answering communications from resident’s representative.

· Cited for 87468.1(a)(9)(14)-Personal Rights

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Sandra Urena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC809 (FAS) - (06/04)
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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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ALL STAR LIVING INC
FACILITY NUMBER: 195850586
VISIT DATE: 02/12/2026
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02/12/2026-Case Management-Deficiency

· 87457 Pre-Admission Appraisal

· 87608 (5)(B)-Postural Supports

· 87303 (a)Maintenance and Operation

· 87555(b)(27)

· HSC 1569.69(b) Medication training

· 87355(e)(1) Criminal Record Clearance

Exit interview conducted. A copy of the report was issued.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Sandra Urena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC809 (FAS) - (06/04)
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