198602264-12-30-2021-11-AS-MVAO-CCENWX-20220311095016

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 12/28/2021
Date Signed: 12/30/2021 12:35:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/25/2021 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20211025125717

FACILITY NAME:	TERRAZA COURT		FACILITY NUMBER:	198602264
ADMINISTRATOR:	GREG BECKER		FACILITY TYPE:	740
ADDRESS:	10955 WASHINGTON BLVD		TELEPHONE:	(310) 838-7800
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	115	CENSUS: 65	DATE:	12/28/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Greg Becker		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Insufficient staffing to meet resident needs
Staff not providing basic laundry services
Resident's room had items covered in feces
Resident did not have bed linens

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Tuesday, December 28, 2021. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA Bunker met with Executive Director Mr. Greg Becker. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker interviewed staff 1-4 (S1-4) and residents 1-6 (R1-6). LPA Bunker asked questions relevant to the nature of the complaint. Mr. Becker and LPA Bunker toured and observed the facility's laundry rooms and resident linen. Executive Director Mr. Becker provided LPA Bunker with a copy of an email letter that he received from the complainant dated 08/20/2021, and copies of the resident roster, personnel report, laundry schedule, and staff ongoing annual training.

See continued LIC8123-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

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 3

Control Number 11-AS-20211025125717

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
	VISIT DATE: 12/28/2021

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
26
27
28
29
30
31
32

Continued LIC9099-C page 2

Allegation #1: Insufficient staffing to meet resident needs
Interviews with staff 1-4 (S1-4) and residents 1-6 (R1-6) all stated the facility has enough staff, the facility hired an outside agency to assist during COVID-19. LPA Bunker observed the personnel report, and staff is receiving ongoing training.

Allegation #2: Staff not providing basic laundry services
Interviews with staff 1-4 (S1-4) and residents 1-6 (R1-6) all stated the facility is providing laundry service weekly, twice a week, and as often as needed. The Memory Care Unit may sometimes need laundry service a little more often. LPA Bunker observed Memory Care laundry Service. R1-6 stated they are happy with the laundry service they are receiving and housekeeping, and the caregivers are doing an excellent job. Residents state the caregivers and housekeeping go above and beyond to keep their laundry clean and not allow it to pile up. The residents stated staff really care about the residents.

Allegation #3: Resident's room had items covered in feces
Interviews with staff 1-4 (S1-4) and residents 1-6 (R1-6) all stated none of the resident's rooms had items covered in feces. The housekeepers and caregivers are always checking residents' rooms and making sure residents' rooms are constantly clean, safe, sanitary, and free of feces at all times for the safety and well-being of residents in placement.

Allegation #4: Resident did not have bed linens
Interviews with staff 1-4 (S1-4) and residents 1-6 (R1-6) all stated the facility has enough bed linen and extra linen if residents need extra linens. Mr. Becker and LPA Bunker observed the resident's bedrooms and there was adequate linen supply for residents during today's visit.

See continued LIC9099-C page 3

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20211025125717

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
	VISIT DATE: 12/28/2021

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
26
27
28
29
30
31
32

Continued LIC812-C page 3

Investigation revealed the following:
Interviews were conducted with staff 1 - 4 (S1 - S4), and Residents 1-6 (R1-R6), who stated the allegation was false. Staff and residents stated residents have enough lined on their beds. There were no residents in another resident room. Staff stated the resident mentioned in the complaint allegations room is on the end. If that happened staff would have re-directed the resident. Staff stated none of the residents had a hand towel hanging in their bathroom or a nightgown in the drawer covered in feces. Staff and residents stated resident's laundry is scheduled for cleaning once a week, some residents twice a week or as often as needed. The resident's laundry basket was not full of dirty laundry. Staff and residents stated the caregivers and housekeeping would not allow the laundry basket to pile up. Housekeeping cleans the rooms daily and would have smelled and odor or observed feces on the hand towel and nightgown while cleaning. Staff stated the facility has an adequate linen supply. If dirty sheets were removed from the resident's bed, staff would replace the sheets with clean sheets. Staff stated residents are assisted with their daily living and staff is providing the necessary care and supervision to meet resident needs. If any residents need additional assistance and require one on one care, there is a service fee between $35.00 - $40.00 an hour. Mr. Becker stated the facility staff is trained, and competent to do their jobs and receives ongoing training. The facility is fully staffed. The facility has hired new employees that are in training. During COVID-19 they hired an agency for extra help. Mr. Becker stated the facility is following Title 22 Regulations regarding staffing. The facility is meeting the staffing criteria. Mr. Becker stated the complainant is nitpicking and reporting duplicate complaints. Staff and residents interviewed denied the allegations.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient 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 is deemed unsubstantiated.

A copy of the Complaint Investigation Report LIC 9099, LIC9099-Cs, and Confidential Names LIC 811 was provided to Executive Director Greg Becker.

There were no deficiencies cited. Exit interview conducted

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 3