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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602406
Report Date: 02/20/2025
Date Signed: 02/20/2025 11:42:37 AM

Document Has Been Signed on 02/20/2025 11:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:ALABASTER ELDERLY CAREFACILITY NUMBER:
198602406
ADMINISTRATOR/
DIRECTOR:		DAVIS, DELORESFACILITY TYPE:
740
ADDRESS:9825 8TH AVENUETELEPHONE:
(323) 971-2964
CITY:INGLEWOODSTATE: CAZIP CODE:
90305
CAPACITY: 6CENSUS: 6DATE:
02/20/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Dolores Davis, Licensee (Owner)TIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On 2/20/2025 at 11:17am an Informal Conference meeting was held at the El Segundo Adult and Senior Care Regional Office. Present during this meeting were Regional Manager (RM) Benita Yates, Licensing Program Manager (LPM) Stephanie Cifuentes, Licensing Program Analyst (LPA) Zina Brown and from Alabaster Elderly Care, Licensee Delores Davis.

On 1/14/2021 the department sent a letter to the facility, making them aware we had been contacted by the California Department of Industrial Relations of an outstanding final judgement against them for Labor Code violations and asking them to contact the Division of Labor Standards Enforcement – Department of Industrial Relations (Labor Commissioners Office) to remain in compliance and avoid any further action.

The department was recently made aware of issues in the payment of the final judgement and met with licensee to discuss importance of compliance with state laws and regulations. Licensee stated she will be working with the Division of Labor Standards Enforcement on a payment plan on 02.22.2025 by 5pm.

Also the department will update the facility phone number today.

An exit interview was conducted with Licensee and a copy of this licensing report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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