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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609050
Report Date: 08/10/2023
Date Signed: 08/10/2023 04:32:40 PM


Document Has Been Signed on 08/10/2023 04:32 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754



FACILITY NAME:TERRAZA OF CHEVIOT HILLSFACILITY NUMBER:
197609050
ADMINISTRATOR:DOINA STEPHANIE RADUFACILITY TYPE:
740
ADDRESS:3340 SHELBY DRTELEPHONE:
(310) 837-9181
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY:100CENSUS: 41DATE:
08/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:53 PM
MET WITH:Robin Culver and Dan Gormliy TIME COMPLETED:
04:30 PM
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On 8/10/2023 Licensing Program Manager (LPM) Eva Alvarez and Licensing Program Analyst (LPA) Alfonso Iniguez attended the facility closure notification meeting. LPM and LPA meet with Robin Culver Executive Director and Dan Gormly-Regional Director of Operations with North Star Management Group.

Today the facility representatives held two notification meetings with Staff, Residents and Responsible Parties:

At 2:00 PM the first meeting was held for staff members, during this meeting staff were informed of the facility building having been sold and the facility closing in 60-days (10/9/2023) or sooner if all residents are relocated prior to the planned closure date.

At 3:00 PM the second meeting was held for the residents and family members. During this meeting, residents and family members were informed of the building sale and closure in 60-days. The residents and family members were provided resource information and written 60-Day eviction notices. The residents and family members were introduced to referral agents to assist them with relocations by 10/9/2023.

A copy of this report was provided to Dan Gormly/Regional Director of Operations with North Star Management.

SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso IniguezTELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2023
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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