197609050-2-25-2022-11-AS-AJKK-CCXVMG-20220328163330

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609050
Report Date: 02/25/2022
Date Signed: 02/25/2022 12:26:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/05/2022 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220105161225

FACILITY NAME:	TERRAZA OF CHEVIOT HILLS		FACILITY NUMBER:	197609050
ADMINISTRATOR:	JOEY ALVARADO		FACILITY TYPE:	740
ADDRESS:	3340 SHELBY DR		TELEPHONE:	(310) 837-9181
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	100	CENSUS: 44	DATE:	02/25/2022
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Cecilio Sapp, Business Office Manager		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Administrator is not following COVID protocol

INVESTIGATION FINDINGS:

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On 02/25/2022, Licensing Program Analyst (LPA) Troy Agard conducted a subsequent complaint investigation at the above facility to address the following allegation. LPA Agard was met with Cecilio Sapp, Business Office Manager and explained the purpose of the visit was to gather information regarding this complaint and deliver findings.

LPA requested copies of the following documents: resident roster, staff roster, and a list of residents receiving home health services.

The investigation consisted of the following: LPA Agard toured the facility, conducted interviews with staff, residents, and a home health aide.

On 02/25/2022, LPA Agard delivered findings.
Cont. on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220105161225

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TERRAZA OF CHEVIOT HILLS	FACILITY NUMBER: 197609050
	VISIT DATE: 02/25/2022

NARRATIVE

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Regarding the allegation: Administrator is not following COVID protocol. It’s being alleged a residents’ Home Health Care Worker is being made to test every 3 days to prove they are COVID negative before entering the facility to work with residents per the Administrator’s directives. The investigation revealed the following: During interviews with the residents, 3 of 5 either denied the allegation to be true or could not confirm. 2 residents were unavailable for interviews. R1 states not being sure if their home health worker has been denied access to the facility due to the new guidance from the Department of Public Health (DPH). “People that come through here already have their shots and it seems like a bit much to ask them to get Covid tested every time they come.” R1 concluded the interview by stating they were not sure if their home health aide had/has been denied access to the facility. R2 and R3 both denied the allegation to be true. R2 states, “Oh no, they are never denied entry. I think they may have more people to see than they can handle but no they are never denied the ability to come see me by the facility. R3 states, they received contractual home health from Kaiser Permanente. R3 confirmed that their home health worker has access and is not denied. “Oh yeah! Home health was here yesterday.” R4 and R5 were unable to be interviewed.

During interviews with staff, 2 out of 2 denied the allegation to be true. S1 states, “we have not refused any health care workers access to the facility. The new guidance from the DPH is going into effect today, but we have been discussing this with the residents.” S2 states, “initially when it was explained to us, we were telling all visitors they needed a test, but they were never denied. We always let them in. There were some that left on their own when we told them about the new guidance, but we never denied them access. Most home health already showed up with their paperwork. Since then, we are aware that essential workers are exempt and do not require a 24-hour negative Covid test. The initial guidance wasn’t very clear.”

During an interview with W1, they denied the allegation to be true. W1 states, “No no no no, I’m not sure what’s going on, you might have to check with the facility, but I have never been refused entry. There’s some new guideline that would require people to have a covid test twice a week or something like that and I do have a client there and there’s no possible way I can get a covid test twice a week. I’m not sure if that was imposed but I was just giving my clients a heads up if that was the case, I would not be able to see them. It has not gotten to that point.”

Based on LPA’s observation, interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of the report was given.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

LIC9099 (FAS) - (06/04)

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