197609050-4-15-2023-11-AS-MVAO-CRVRVR-20230516132159

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609050
Report Date: 04/15/2023
Date Signed: 04/15/2023 09:36:32 AM

Unsubstantiated

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
03/09/2023 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230309084726

FACILITY NAME:	TERRAZA OF CHEVIOT HILLS		FACILITY NUMBER:	197609050
ADMINISTRATOR:	DOINA STEPHANIE RADU		FACILITY TYPE:	740
ADDRESS:	3340 SHELBY DR		TELEPHONE:	(310) 837-9181
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	100	CENSUS:	DATE:	04/15/2023
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Mia Rabino, Dining Director		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not following proper food- service sanitation practices.
Staff do not accord resident dignity and respect.
Staff do not accord resident privacy.
Staff took resident's belongings without permission.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

This amended report supersedes report dated 03/15/23. Licensing Program Analyst (LPA) Ana Soto conducted an unannounced subsequent visit to deliver findings and decisions for the allegations listed above. Today’s complaint visit was conducted with Mia Rabino, Dining Director

The investigation consisted of following: Interviews, Record reviews, and LPA observations. LPA toured 2nd floor room #50 & room #54, 1st floor Dining room, kitchen, Lobby, Theatre room, Game room, room #26. LPA observed following: kitchen meals preparations, resident aide delivering meals to residents rooms, staff setting up dining room for lunch. LPA Soto interviewed S#1 - Executive Director, S#3 - S#6, R#1 - R#4.
LPA requested and received the following documents and partial file for R#1 & R#3:Resident Roster, Staff Schedule R#1 & R#3 (Face sheet, Physician's Report, Admissions agreement, Pre-Appraisal, Needs and Services Plan.) Staff meeting training for Treating Residents with Respect.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2023

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 3

Control Number 11-AS-20230309084726

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: 04/15/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the LPA's investigation, the investigation revealed the following. For Allegation 1 – Staff are not following proper food- service sanitation practices. According to complaint staff are not using gloves to deliver meals to residents room. Interviews conducted with S#1, communicated that the staff is required to wear gloves when delivering the food trays to the residents. They practice sanitary procedures. The kitchen staff always wear gloves when handling food. S#2 - S#3, communicated that they believe that the staff that takes the food to residents wear gloves. S#4 - S#5, communicated that they always wear gloves when handling food in the kitchen. They have always used gloves when preparing the food for resident's. S#6, communicated that every time they serve the food to residents they use gloves. They make sure they carry gloves all the time. They need them for the food and to help the residents with their ADL's. Interviews conducted with R#2 - R#4, communicated thay have never had problems with staff and their food. As far as they know, the staff always wears gloves. LPA observed staff using gloves while taking food trays to the residents. The kitchen staff was also wearing gloves while preparing the food in the kitchen for lunch. The interviews and observations did not concur with the above allegation.

Allegation 2 -Staff do not accord resident dignity and respect. According to complaint staff did not want to give additional condiment's for a meal. Interviews conducted with S#1 - S#6, the facility always gives the residents anything they request. Usually depending on the meals, the resident is given mayonnaise, ketchup, and mustard. If the resident request more the staff will take them more. The residents are never denied anything they request. Unless the facility has run out of that item and has no more. The facility will offer other options in those cases. Interviews conducted with R#2- R#4, communicated that they have never been denied anything, staff always gives them what they want. The staff is great. The staff has never disrespect them. LPA reviewed training (treating resident's with respect) completed on 10-25-22, 19 out of 31 staff attended training. The facility makes sure staff is always aware on how to treat residents. Interviews and record reviewed did not concur with the above allegation.

Allegation 3 -Staff do not accord resident privacy. According to complaint staff always insists on having resident join activities. Interviews conducted with S#1, communicated that S#1 always goes around the facility reminding residents about the activities that the facility offers. They never make anyone do anything they don't want to do. But, they do try to encourage residents to be social and participate in the facilities daily activities. S#2 - S#6, communicated that they never make residents participate in any of the activities if they don't want too. They let them know what's happening at the facility, but they don't make them do anything they don't want or feel comfortable doing. Interviews conducted with R#2 - R#4, communicated

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 11-AS-20230309084726

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: 04/15/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

that they are never made to do anything they don't want to do. The staff is good and nice. The staff is very helpful. They all like it at the facility. The interviews conducted did not concur with the above allegation.

Allegation 4 -Staff took resident's belongings without permission. According to complaint staff taking facility cups out of room without asking. Interviews conducted with S#1 - S#6, communicated the staff never takes anything out of the resident's rooms without permission. The things they take out without residents permission is their trash and dirty dishes after meals. Interviews conducted with R#2 - R#4, communicated that the staff has never taking anything of their stuff from them and are very nice. The facility and staff are great. The interviews conducted did not concur with the above allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated

An exit interview was conducted with Mia Rabino, Dining Director, and a hard copy of report was provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3