198320456-1-26-2026-11-AS-SCIS-DSG23L-20260323170230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 01/26/2026
Date Signed: 01/26/2026 04:19:17 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
01/21/2026 and conducted by Evaluator Felisa Shirley

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260121093218

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: 107	DATE:	01/26/2026
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Michelle Brown, Wellness Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff do not ensure resident's hygiene needs are met

INVESTIGATION FINDINGS:

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On 1/26/26, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Wellness Director, Michelle Brown and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:

On 1/26/26 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, Identification and Emergency Information, Physician’s Report, RCFE Service Plan, Resident Appraisal, Appraisal Needs and Services, Laundry Schedule, and Shower Schedule. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff 6 (S1 – S6), and Resident -1 – Resident -8 (R1-R8).

Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

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-20260121093218

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: 01/26/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Staff do not ensure resident’s hygiene needs are met

It is being reported that a resident was not groomed properly. On 1/26/26, LPA Felisa Shirley reviewed the resident’s Laundry List and observed that R1’s laundry is cleaned on Thursdays. On 1/26/26, interviews with S1 -S6 stated, R1 showers on their own. Staff stated that staff stands by and assist as R1 needs and request. Per review of R1’s Appraisal/Needs and Services plan dated 5/17/24, staff should assist as needed in the process of Activities of Daily Living, ADL’s. LPA Shirley interviewed R1 and he stated that assistance is not needed by the staff as R1 showers and grooms himself.

LPA interviewed staff 1 – staff 6 (S1 – S6). Of those interviewed 6 out of 6 denied the allegation. LPA interviewed Resident 1 – Resident 8(R1 – R8). Of those who interviewed 4 out of 8 denied the allegation and 4 showers on their own.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff do not ensure resident's hygiene needs are met,” therefore, the allegation is unsubstantiated.

No deficiencies were cited for these allegations.

An exit interview was conducted and a copy of this report was provided to the Wellness Director, Michelle Brown.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC9099 (FAS) - (06/04)

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