198320456-8-21-2025-11-AS-SCIS-DLUTEM-20250925144010

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 08/21/2025
Date Signed: 08/21/2025 04:33:40 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/12/2025 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250812110146

FACILITY NAME:	TERRAZA COURT SENIOR LIVING		FACILITY NUMBER:	198320456
ADMINISTRATOR:	KAVANAUGH, BRITTANY		FACILITY TYPE:	740
ADDRESS:	10955 WASHINGTON BLVD		TELEPHONE:	(310) 838-7800
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	170	CENSUS: 83	DATE:	08/21/2025
		UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:	Michelle Brown		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff did not safeguard residents personal belongings.

INVESTIGATION FINDINGS:

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On 08/21/25, Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced complaint visit to investigate the allegation mentioned above. LPA met with Wellness Director, Michelle Brown, and explained the purpose of the visit. LPA was granted access to the facility.

The investigation consisted of the following: LPA requested the staff and resident rosters. Reviewed five (5) resident files and collected the following records: ID and Emergency Information, Residence and Care Agreements, Move in Records (Face Sheets), Resident Personal Property and Valuables, Theft and Loss Policy, and Unusual Incident/Injury Report (dated: 07/09/25). LPA conducted interviews with residents #1-#7 (R1-R7) and staff #1-#6 (S1-S6). Additionally, LPA conducted a tour of the facility.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025

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-20250812110146

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: TERRAZA COURT SENIOR LIVING	FACILITY NUMBER: 198320456
	VISIT DATE: 08/21/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not safeguard residents personal belongings. It is being alleged that someone is going into the residents and stealing their belongings. On 08/21/25, between 11:00 AM and 12:30 PM, LPA conducted interviews with S1-S6. Of those interviewed, 6 out of 6 staff denied the allegation. 4 out of 6 staff said that they were not aware of any resident reporting any missing items, and 2 out of 6 staff said they were aware of a resident reporting a stolen item. S1-S2 stated that when a resident reports a missing or stolen item, they will do a sweep and look for the item, they will talk with staff and other residents to see if they know anything about the missing item, and that they will involve the police if they feel the need to.

On 08/21/25, between 1:30 PM and 3:00 PM, LPA conducted interviews with R1-R7. Of those interviewed, 7 out of 7 residents denied the allegation. 6 out of 7 residents said they haven’t had an issue with their personal belongings missing or stolen. 7 out of 7 residents said they believe they are responsible for keeping their valuables safe and secure.

A review of Unusual Incident/Injury Report dated 07/09/25 revealed that on 07/08/25 a resident informed staff that their debit card was stolen and used at a local 7-11. Staff spoke with that residents Power of Attorney (POA), and they provided the exact timing and amounts of the transactions. Staff went to the 7-11 and confirmed that it was the residents roommate who had used the debit card. Staff called Culver City Police Department, and an investigation was conducted. Staff offered the to relocated the resident (victim) to a private room. Although it did happen, the facility took the proper steps and called law enforcement, reported it to Community Care Licensing Department (CCLD), and other applicable agencies.

Based on observation, interviews conducted, and a review of records, there is insufficient evidence to support the allegation. 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 this report

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025

LIC9099 (FAS) - (06/04)

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