198602264-3-14-2022-11-AS-AJKK-CCQNMB-20220321103449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 12/21/2021
Date Signed: 03/14/2022 03:37:51 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
09/08/2021 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20210908155251

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:	12/21/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Greg Becker		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff are not adequately trained
Staff did not follow doctor's orders to prevent the spread of scabies
Staff did not inform resident's authorized representative of a change in condition
Staff did not meet resident's toileting needs
Staff did not seek dental care for resident in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Tuesday, December 21, 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 Greg Becker. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker interviewed staff 1-3 (S1-S3) and residents 2-6 (R2-R6) LPA Bunker asked questions relevant to the nature of the complaint. On 09/15/2021 at 12:20 P.M., Executive Director and LPA Bunker toured the Memory Care Unit. We observed eight (8) resident's apartments #125, 127, 129, 136, 137, 138, 139, and 140. LPA Bunker requested copies of the following: personnel report, residents roster, care staff on-going training, physicians reports, medication log, medical administration records (MARs), medication annual training verification form, laundry schedule, the housekeeping schedule, and any other pertinent documents associated with this complaint.
See continued LIC9099-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: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

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-20210908155251

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: 12/21/2021

NARRATIVE

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Continued LIC9099-C page 2

Allegation #1 Staff are not adequately trained. Staff 1-3 (S1-S3) interviewed stated staff are trained and are receiving ongoing training. LPA Bunker observed staff training and staff are competent, trained, and providing the necessary care and supervision to meet the resident needs. Mr. Becker stated staff does have the proper and sufficient training. The facility has hired new employees that are going through training.
Interviews with residents 2-6 (R2-R6) all feel the staff is trained to assist with their daily needs, there is enough staff working, and staff is providing residents with care and supervision.

Allegation #2 Staff did not follow the doctor's orders to prevent the spread of scabies. Staff 1-3 (S1-3) interviewed stated that there was no spread of scabies. R1 had a rash. On Thursday, September 02, 2021, R1 saw her doctor and was diagnosed with dermatitis, not scabies. On 09/23/2021 R1 doctor prescribed Ivermectin (STROMECTOL) 3 mg Oral Tab, take 5 tablets by mouth and again in 7 days, Clobetasol 0.05% ointment to affected areas twice daily as needed for itching, and Sarna Sensitive (pramoxine) 1 % to affected areas as often as needed for itching, and Benadryl 12.5 mg (1/2 25 mg tablet) by mouth at night only. The facility had no documentation of any residents with scabies. Mr. Becker stated they are following R1's physician’s orders. Mr. Becker stated he has observed staff putting cream and ointment on R1's rash. Mr. Becker stated no one at the facility has scabies and there is no scabies outbreak. R2-R6 interviewed stated they do not have scabies and were unaware of any residents having scabies.

Allegation #3 Staff did not inform the resident's authorized representative of a change in condition.
Staff 1-3 (S1-S3) interviewed stated they always notify the family members or responsible party of any changes in the resident's medical condition. The family is notified daily of any changes to resident health. They are constantly calling and emailing family members with updates. Residents 2-6 (R2-R6) stated if there is a change in their condition their family members are notified.

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: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20210908155251

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: 12/21/2021

NARRATIVE

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Continued LIC9099-C page 3

Allegation #4 Staff did not meet the resident's toileting needs. Staff 1-3 (S1-S3) interviewed stated they are meeting residents' toileting needs. The caregivers are changing the residents as often as required. Staff is providing the necessary care and supervision. Mr. Becker provided LPA with a copy of the housekeeping schedule. Memory care is cleaned daily and they have a designated housekeeper that spots check and cleans throughout the day. Residents 2-6 (R2-R6) stated staff is meeting their toileting needs.

Allegation #5 Staff did not seek dental care for the resident in a timely manner. Staff 1-3 (S1-S3) interviewed stated. The family will make residents' dental appointments and take them to their appointments. the facility doesn't handle memory care dental needs. Staff stated if they noticed a change in residents' dental care they will contact the family and responsible party. Residents 2-6 (R2-R6) stated staff will contact their family members if they need any dental care.

Investigation revealed the following: Interviews were conducted with staff 1-3 (S1-S3), and Residents 2-6 (R2-R6) who stated the allegations are false. Staff stated they are trained and are receiving ongoing training. Staff stated there was no spread of scabies or any outbreaks of scabies. Staff state R1 had a rash and was diagnosed with Dermatitis. Staff stated prescribed medications are being administered according to the doctor's orders. Staff is responsive daily in observing for any changes in resident's health. Staff stated they always notify the family members or responsible party of a change in the resident's medical condition. Residents' daily care needs are being met and they are meeting the residents' toileting needs. Staff stated if there is a dental problem with one of the residents they will contact the family. Staff stated in the memory care unit the family members handle residents' dental appointments and take residents to their appointments. Staff and residents denied 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: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

LIC9099 (FAS) - (06/04)

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