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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 09/03/2025
Date Signed: 09/03/2025 04:15:17 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
08/27/2025 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250827130833
FACILITY NAME:TERRAZA COURT SENIOR LIVINGFACILITY NUMBER:
198320456
ADMINISTRATOR:KAVANAUGH, BRITTANYFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:170CENSUS: 109DATE:
09/03/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Michelle Brown - Wellness DirectorTIME COMPLETED:
04:36 PM
ALLEGATION(S):
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Staff did not assist a resident in care with transportation.
INVESTIGATION FINDINGS:
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On 09/03/25 Licensing Program Analyst (LPA) Mario Leon conducted an initial complaint visit at the facility. LPA was met by staff one, Michelle Brown (S1), and the purpose of the visit was explained.
The investigation consisted of the following: between 09:50AM and 10:50AM LPA requested the staff and resident rosters and three (3) resident files which include Admission Agreements (dated: various), Physician's reports (dated: various) and one (1) notification to residents (dated: 05/01/25). LPA conducted interviews with residents #1-#5 (R1-R5) and staff #1-#5 (S1-S5) and LPA toured the facility.
The investigation revealed the following: Regarding the allegation, “staff did not assist a resident in care with transportation”, it is being alleged that the facilities’ vehicle is inoperable which has resulted in personal rights violation for resident(s) in care. Between 11:05AM and 3:15PM, LPA interviewed R1-R5 and S1-S5. Three (3) out of five (5) residents and all five (5) staff have denied the allegation has taken place. All five staff have informed LPA that residents are provided transportation when transportation is necessary. S5 has stated that numerous automotive shops have denied service to the van, but that a transmission shop in Burbank has accepted to inspect the van's transmission (dated: 09/05/25). Report continues, please see LIC9099-C.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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 2
Control Number 11-AS-20250827130833
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: 09/03/2025
NARRATIVE
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Record reviews revealed that a notification regarding the facility's van being out of service (dated 05/01/25). Within this notification there are written regulation(s) regarding scheduling and distance, to be provided by Uber and Access, which has been provided to residents and their responsible parties, on 05/01/25.

Based on record reviews and 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2