198602264-3-11-2022-11-AS-AJKK-CDQUVH-20220422155509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 03/11/2022
Date Signed: 03/11/2022 02:52:30 PM

Unsubstantiated

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
11/22/2021 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20211122084921

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: 64	DATE:	03/11/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Business Office Manager, Galina Tovmasima		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has scabies.

INVESTIGATION FINDINGS:

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

On 03/11/2022 Licensing Program Analyst (LPA) Troy Agard conducted a subsequent complaint investigation at the above facility to address the following allegations. LPA Agard was met with Business Office Manager, Galina Tovmasima and explained the purpose of the visit was to gather information regarding this complaint.

The investigation consisted of the following: On 11/22/2021, LPA conducted a 10-day visit and met with Galina Tovmasima. LPA toured the facility and completed interviews and requested copies of facility records. On 03/11/2022, LPA conducted additional interviews.

On 03/11/2022, LPA Agard delivered findings.

Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

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 2

Control Number 11-AS-20211122084921

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: 03/11/2022

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

Regarding the allegation: Facility has scabies. It’s being alleged a resident has the appearance of a rash that is similar to that of a person with scabies. The investigation revealed the following: During interviews with staff, 0 of 5 confirmed the allegation to be true, 5 of 5 confirmed the allegation to be false. S1- S5 all denied the allegation to be true. S1 states, “R1 had skin irritation and was being treated for that, not scabies.” S2 states, “we have never had an outbreak. R1 has never had scabies.” S3 states, “back in November, no one has reported that anyone had scabies.”

During interviews with the residents, 0 of 6 confirmed the allegation to be true, 4 of 6 confirmed the allegation to be false and 2 were unable to interview. R1 was unable to interview due to cognitive impairment. R2-5 all denied knowing anything about the allegation or hearing anything about it. R2 states, “No, I have not heard about scabies.” R3 states, “nope, never heard that.” R6 was unable to interview.

During interviews with the witnesses, 4 of 4 denied the allegation to be true. W1 states, I investigated the resident that was accused of having scabies and it turned out that the resident did not have scabies. The reporting party does not have a medical background and therefore my supervisor had me close it out as a false positive. W2-4 all denied being aware, informed or overhearing about a resident having scabies. W2 states, “I never heard of that. R1 was being treated for a rash. It was never scabies.”

During a record review, medical records for R1 show that resident was being treated for a skin rash and not scabies. No treatment noted on R1's medication administration records for scabies.

Based on LPA’s observation, interviews conducted, and record review, the preponderance of evidence standard has not been met. 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 unsubstantiated.

An exit interview was conducted, and a copy of the report was given.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2