198320456-6-15-2026-11-AS-PMAA-DWNPXR-20260805114247

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 06/15/2026
Date Signed: 06/15/2026 03:13:02 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
06/09/2026 and conducted by Evaluator Zina Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260609085800

FACILITY NAME:	TERRAZA COURT SENIOR LIVING		FACILITY NUMBER:	198320456
ADMINISTRATOR:	LINDA POYTHRESS		FACILITY TYPE:	740
ADDRESS:	10955 WASHINGTON BLVD		TELEPHONE:	(310) 838-7800
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	170	CENSUS: 114	DATE:	06/15/2026
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Linda Poythress (Administrator)		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility staff abandoned resident at the hospital

INVESTIGATION FINDINGS:

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On 06/15/2026 at 8:45am, the Department conducted an initial complaint visit at the facility listed above. The Department met with Linda Poythress (Administrator) and explained the purpose of the visit.

The investigation consisted of the following: On 06/15/2026, the Department conducted interviews with A1, Staff (S1 - S6) and Residents (R1 - R10) between the hours of 09:00am - 12:00pm. The Department requested and obtained the following documentation such as staff roster (dated 05/19/2026), resident roster (dated 06/15/2026) SOC 341 Report of Suspected Dependent Adult/Elder Abuse (dated 04/13/2026 & 04/24/2026), Resident 1's documentation such as LIC 602A Medical Assessment for Residential Care Facilities for the Elderly (dated 06/04/2026, 03/31/2025, & 02/25/2026 ), UCLA Health Patient Summary (date of service 06/05/2026), Resident Assessment/Service Plan (Dated February 2026), Resident Return from Extended Leave Policy & Procedure, Staff Memory Care Schedule (June 2026), Pre-and Re-Assessment(dated 05/26/2026), Discharge Summary (dated 06/10/2026) and Communication Logs (April 2026 - June 2026)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

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-20260609085800

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: 06/15/2026

NARRATIVE

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On 06/15/2026, between the hours of 1:30pm – 2:40pm, the Department conducted a records review and observed the following: the facility’s Resident Return from Extended Leave Policy & Procedure states that residents returning from hospitalization or any absence exceeding seven (7) days must be assessed prior to readmission, and the facility may require updated medical documentation to determine whether it can safely meet the resident’s needs. R1’s Pre- and Re-Assessment (dated 05/26/2026) documented traumatic brain injury, mental health challenges, memory loss, behavioral triggers, a history of aggression, and the need for assistance with activities of daily living and medication management. The communication log reflected ongoing contact between the facility and UCLA from 05/04/2026 through 06/06/2026, including repeated requests for updated clinical information and the LIC 602. Documentation showed the facility received the updated LIC 602 on 06/04/2026, completed the assessment on 05/26/2026, and confirmed R1’s return hospital on 06/05/2026. Hospital records (dated 06/08/2026) indicated R1 was medically cleared, stable for discharge, and appropriate for return to the facility. R1’s LIC 602 (dated 06/04/2026) listed diagnoses of acute psychosis, schizophrenia, and traumatic brain injury and confirmed R1 required staff assistance with medication administration.

Based on information gathered through interviews and record reviews, there is not enough 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 isUNSUBSTANTIATED.

Exit interview conducted with Michelle Brown (Wellness Director) and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260609085800

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: 06/15/2026

NARRATIVE

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The investigation revealed the following:
Allegation: Facility staff abandoned resident at the hospital.
It was alleged that the facility did not ensure the resident’s return from the hospital after resident was medically cleared, resulting in the resident remaining at the hospital for an extended period.

On 06/15/2026, between the hours of 09:00am – 09:15am, the Department conducted an interview with A1. A1 denied the allegation and stated she was notified by the Memory Care Director that R1 had been admitted to the hospital on a 5150 hold. A1 reported becoming aware of R1’s medical clearance approximately two weeks after 05/03/2026 when contacted by a social worker from UCLA Santa Monica. A1 stated R1 had been transferred between multiple hospitals and that the facility experienced delays in receiving the required medical documentation. A1 reported the facility completed an assessment prior to R1’s return and maintained ongoing communication with the hospital through multiple phone calls until the updated LIC 602 and clinical information were received. A1 stated the facility’s policy requires a 72 hour alert period to monitor residents returning from hospitalization and reported that R1 adjusted well upon returning. A1 stated the plan is for R1 to remain at the facility.

On 06/15/2026, between the hours of 10:15am – 12:00pm, the Department conducted 6 staff interviews in regards to the allegation. 3 out of 6 staff denied the allegation and stated they had not heard any discussion about R1 being refused return to the facility. 3 out of 6 staff were unaware of the allegation and reported they were not aware of R1’s hospitalization or return status due to working in the assisted living unit while R1 resides in the memory care unit.

On 06/15/2026, between the hours of 9:24am – 11:15am, the Department conducted 10 resident interviews in regards to the allegation. 10 out of 10 residents denied the allegation and stated they were not aware of any residents who had been hospitalized and experienced difficulty returning to the facility. Of the 10 residents, 9 residents reported having been hospitalized while residing at the facility for various reasons, including stroke/high blood pressure (R2), diabetes (R3), a busted lip requiring stitches (R4), a medication change (R5), a broken leg (R6), an infection (R8), surgery (R9), and a fall requiring stitches (R10). All 9 residents confirmed they were able to return to the facility without issue. While 1 resident (R7) reported no history of hospitalization.

Investigation findings continue on LIC 9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

LIC9099 (FAS) - (06/04)

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