198602264-6-8-2022-11-AS-UCOL-CFSUA4-20220627152406

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 02/04/2022
Date Signed: 06/08/2022 03:08:33 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
01/27/2022 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20220127124528

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:	02/04/2022
		UNANNOUNCED	TIME BEGAN:	10:09 AM
MET WITH:	Greg Becker		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff not assisting residents as needed.
Unqualified staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Friday, February 04, 2022. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared 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. Staff and residents stated staff does assist residents with their daily needs as needed. Executive Director Mr. Becker stated the facility does mass COVID-19 testing for the staff and residents weekly. If a staff or residents have positive results it is reported to all the appropriate agencies timely. Staff interviewed stated if staff is off work and in quarantine due to COVID-19. The facility staff will not call staff to come to work. The facility has alternate cooks available to assist if a cook is out on quarantine. LPA Bunker requested and reviewed staff records.
See continued LIC812-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: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

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 3

Control Number 11-AS-20220127124528

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: 02/04/2022

NARRATIVE

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Continued LIC9099-C page 2

Allegation #1 Staff not assisting residents as needed: All staff and residents stated the facility has adequate staff available to assist residents. Staff provided proof of contract that the facility hired an outside agency ACG-Training Management & Consulting Inc., to assist staff during COVID-19. LPA Bunker observed the personnel report, according to Title 22 Regulations the facility has enough staff to provide the necessary care and supervision to meet the resident's needs 24 hours a day. Residents stated they are happy and their care needs are being met. LPA Bunker requested copies of supporting documents.

Allegation #2 Unqualified staff: All staff and residents interviewed stated if there are positive COVID-19 results they are notified immediately. S1-S4 stated staff is trained, qualified and competent to do their jobs. Mr. Becker stated staff is receiving ongoing training. S1-S4 stated the facility is following Title 22 Regulations regarding Infection Control. The facility has an approved Mitigation Plan Report on file. The facility will call the resident's family, and send emails, the residents are notified door to door with a memo, and it is posted throughout the facility if a resident or staff test results are positive for COVID-19. Mr. Becker stated everyone is notified if there is a positive COVID-19 case. If staff and residents had any questions staff is available to answer questions. Staff 1-4 stated staff did not call any staff or cook that was out on quarantine to come into work to cook. The facility has relieved cooks that are available to assist if a cook is out.

Investigation revealed the following: Interviews were conducted with staff 1-4 (S1-S4), and residents 1-6 (R1-R6), who stated the allegations are false. Staff stated residents are assisted with their daily living, and staff is providing the necessary care and supervision to meet resident's needs. Mr. Becker stated the facility staff is trained, qualified, and competent to do their jobs and receives ongoing training. LPA reviewed the facility’s surveillance testing records. LPA verified that the facility has an approved Mitigation Plan Report. Mr. Becker stated some of the staff and all residents are fully vaccinated. The facility is adequately staffed. The facility has hired new employees that are in training. During COVID-19 the facility hired an agency for extra help. Mr. Becker stated the facility is following Title 22 Regulations regarding staffing. S1-S4 stated if staff is off work and is in quarantine due to COVID-19. The facility staff will not call staff that is off work due to illness to come into work. The facility has alternate cooks available to assist if a cook is out on quarantine. The facility is meeting the staffing criteria. Mr. Becker stated the facility has also hired ACG-Training Management & Counsulting Inc., to assist with staffing. 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: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20220127124528

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: 02/04/2022

NARRATIVE

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Continued LIC812-C page 3

Mr. Becker stated that whenever they receive a positive COVID-19 test result it is reported to all the appropriate agencies, Community Care Licensing, Los Angeles County Public Health Department, resident's family, responsible party, staff and residents are notified immediately. Staff 1-4 (S1-S4) and residents 1-6 (R1-R6) interviewed all 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.

*** Please note that this is an amended LIC9099, LIC9099-Cs to the original LIC9099 and LIC9099-Cs dated 02/04/2022. ***

A copy of the Complaint Investigation Report LIC 9099, LIC9099-Cs, and Confidential Names LIC811 was provided to Executive Director Greg Becker and Business Office Manager Galina Tovmasian.

There were no deficiencies cited.

An exit interview was conducted.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

LIC9099 (FAS) - (06/04)

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