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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 11/05/2025
Date Signed: 11/05/2025 02:40:23 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
10/27/2025 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20251027134919
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: 98DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brittany KavanaughTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility is not adhering to their plan of operation.
INVESTIGATION FINDINGS:
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On 11/5/25, at 10:00am, the department conducted an initial complaint visit to the facility and was greeted by Brittany Kavanaugh, Executive Director. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, interview staff and residents, and deliver findings for the allegation mentioned above.

The investigation consisted of the following: The department investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S4) and resident (R1). The department received the following facility documents: Resident Roster (Date: 11/05/2025), Staff Roster (Dated:10/23/2025), Physician Report (Dated: 03/21/2025), ID/Emergency Information (Dated: 04/01/2025), Preplacement Appraisal Information (Dated: 04/01/2025), Appraisal & Needs Service Plan (Dated: 04/20/2025), Psychiatric Evaluation (Dated: 08/05/2025, 09/02/2025, 10/01/2025), Clinical Requisition (Dated: 07/20/2025, 09/03/2025), RCFE Plan of Operation Addendum (Dated: 10/30/2025), and Unusual Incident Reports LIC624 (Dated:06/23/2025, 10/26/2025 ) from the facility.

Report Continued on LIC909-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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-20251027134919
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: 11/05/2025
NARRATIVE
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The investigation revealed the following: Allegation- Facility is not adhering to their plan of operation.

The details of the complaint alleged that the facility is not adhering to their plan of operation by having a resident that may need a higher level of care. It was reported that the resident is residing in memory care and does not seem to be correctly placed, as they seem to suffer from psych related issues as opposed to age related memory loss. Consequently, it was reported that the residents in the memory care wing may be at risk, as they are not able to defend themselves. On 11/5/2025, from 10:00am-2:00pm, the department interviewed staff (S1-S4) and resident (R1) regarding the allegation. 4 of 4 staff denied the allegation that Facility is not adhering to their plan of operation. All staff (S1-S4) stated they are adhering to their plan of operation and that R1 does not have a mental disorder diagnosis and is appropriately placed in the facility. Staff stated that R1 does not require 24-hour or skilled nursing care and is placed in memory care due to their physician’s diagnosis. Staff also stated that R1 has continued to take their medications as prescribed.

The department interviewed resident (R1) about the allegation and the resident stated that they were happy with the care and supervision provided by the staff and that they did not have any problems with living at the facility.

The department reviewed the Physician Report (Dated: 03/21/2025), Psychiatric Evaluation (Dated: 08/05/2025, 09/02/2025, 10/01/2025), Preplacement Appraisal Information (Dated: 04/1/2025), Appraisal & Needs Service Plan (Dated: 04/2025), and Unusual Incident Reports LIC624 (Dated:06/23/2025, 10/26/2025). The department did not observe in any of the medical documents that the resident may have been placed at the facility incorrectly. Additionally, the department did not observe that the resident has a psychiatric diagnosis and that the facility has regular psychiatric evaluations of the resident.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Facility is not adhering to their plan of operation. 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.

No citations were issued.

An exit interview was conducted with Brittany Kavanaugh, Executive Director, and a hard copy of this Complaint Investigation Report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
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