<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610419
Report Date: 02/12/2024
Date Signed: 02/12/2024 02:06:19 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2024 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20240202164342
FACILITY NAME:ALL STAR CARE INCFACILITY NUMBER:
197610419
ADMINISTRATOR:DARABEDYAN, IVETAFACILITY TYPE:
740
ADDRESS:36240 52 ST EASTTELEPHONE:
(818) 624-6006
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:6CENSUS: 5DATE:
02/12/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Iveta DarabeyanTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff withheld food from residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tuesday Cabiness conducted an initial complaint investigation and met with Administrator Iveta Darabeyan, who was informed the reason of the visit. The following was determined during the visit.

It was alleged staff withheld food from residents in care. To investigate this matter, from 10:15am to 2pm, LPA conducted interviews with residents and staff and conducted a physical plant inspection of the kitchen area and the facility’s food. LPA observed the facility met Licensing requirements for perishable and non-perishable; but interviews reported the facility does not provide an adequate amount of food for meals. During today’s visit, LPA observed residents eating (1) hamburger for lunch. LPA also observed staff giving residents a piece of candy, 3 cookies, and a piece of banana. The quantity or variety was insufficient, and residents reported not getting enough food. LPA also observed the facility had locks on cabinets where food was kept. This is an immediate health and safety risk to residents in care. Therefore, based on observations and interviews the allegation is Substantiated
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 31-AS-20240202164342
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALL STAR CARE INC
FACILITY NUMBER: 197610419
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/13/2024
Section Cited
CCR
87555(a)
1
2
3
4
5
6
7
General Food Service Requirements: (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board...This requirement was not met, evidenced by:
1
2
3
4
5
6
7
The Administrator will train and meet with staff on providing enough meals for the residents; as well as discussing appropriate snacks. Administrator will email LPA when training and discussion with staff take place.
8
9
10
11
12
13
14
Based on observations and interviews, the facility does not provide an adequate amount of food for meals. This is a immediate health and safety risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2