<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602264
Report Date: 11/06/2020
Date Signed: 07/26/2021 12:10:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:TERRAZA COURTFACILITY NUMBER:
198602264
ADMINISTRATOR:JUNGE, PAMELAFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:115CENSUS: 62DATE:
11/06/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Greg Becker, staffTIME COMPLETED:
05:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Jennifer Jones initiated a case management for the facility above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures, today’s case management visit was conducted via Facetime with Greg Becker, staff.

While conducting complaint investigation 11-AS-20201102104040, LPA asked Greg Beck who is currently the administrator for the facility. Greg Becker was unable to confirm who is the administrator is for the facility. Greg advised LPA that Evelyn Mendez' Choy and himself are assisting with overseeing the facility until they hire a new administrator. Greg advised LPA during the call that he will find out if another administrator name Jessie is still the current administrator and will call LPA back.


Deficiencies cited on 809D

A telephonic exit interview was conducted with Greg Becker and a hard copy was provided via email for signature
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TERRAZA COURT
FACILITY NUMBER: 198602264
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/06/2020
Section Cited

1
2
3
4
5
6
7
All facilities shall have a qualified and currently certified administrator. This requirement is not met as evidence by: During the call, staff Greg Becker was unable to identify who the current administrator is for the facility.

1
2
3
4
5
6
7

1
2
3
4
5
6
7

1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Angela J KendrickTELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer JonesTELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2