198602264-1-24-2021-11-AS-MVAO-BYCPL8-20210218102418

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 01/24/2021
Date Signed: 01/24/2021 03:35:14 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
11/02/2020 and conducted by Evaluator Jennifer Jones

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20201102104040

FACILITY NAME:	TERRAZA COURT		FACILITY NUMBER:	198602264
ADMINISTRATOR:	JUNGE, PAMELA		FACILITY TYPE:	740
ADDRESS:	10955 WASHINGTON BLVD		TELEPHONE:	(310) 838-7800
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	115	CENSUS: 54	DATE:	01/24/2021
		ANNOUNCED	TIME BEGAN:	12:36 PM
MET WITH:	Greg Becker, Administrator		TIME COMPLETED:	03:37 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not meeting resident's dietary needs.
Staff are not qualified to prepare food for resident.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Jennifer Jones initiated a subsequent complaint investigation for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures, today’s complaint investigation was conducted via Facetime with Greg Becker, staff. LPA explained the purpose of this telephonic visit is to gather information regarding the complaint allegation.

During the visit on 11/06/20, LPA toured the kitchen and observed food in cabinets, refrigerator and freezer. During the call, LPA requested the following documents: Staff roster with positions, staff schedules and staff contact information, resident roster, menu and pureed diet menu if different and a facility grocery invoice list.

On 01/24/21, LPA Jones delivered findings to the administrator, Greg Becker.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer Jones	TELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2021

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 2

Control Number 11-AS-20201102104040

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: 01/24/2021

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

The investigation revealed the following: For allegation (Staff are not meeting resident's dietary needs.) It was alleged that the facility staff are blending resident's food together without a doctor’s order and resident's are not getting a well balanced meal. On 11/06/20, LPA Jones virtually toured the kitchen and observed three days of perishable food items and one week of non-perishable food items. LPA observed a variety of meats, fresh fruits, frozen fruits and vegetables. The administrator, Greg Becker emailed LPA Jones the facility food menu and the credentials of the facility cook. The administrator stated the facility has a certified cook who prepares the food for the residents. The administrator stated that they follow the doctor's order for all residents who are on pureed diets. Staff 2-10 stated that the cooks prepares the food and they only assist with serving it to the residents at times. Residents 1-5 revealed during their interviews that they receive a sufficient amount of food. Some of the residents mentioned that the food is a variety but they do not always like the taste of it.

For allegation: (Staff are not qualified to prepare food for resident.) It is being alleged that the facility does not have a chef and non-qualified facility staff are preparing the food. The administrator, Greg Becker advised LPA Jones that the facility does have a certified cooks and sent LPA their credentials. The administrator stated that different staff will deliver the food to the rooms but they do not prepare the food. Staff 2- 10 revealed during their interviews with LPA Jones that the facility has cooks in the kitchen but they do not know their certifications. Staff 2-10 stated that the facility is short staff and they've been workings additional hours but they have not been asked to prepare food in the kitchen. Residents 1-5 stated that they do not know who prepares their food.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

An electronic cope of the report was emailed to the administrator Greg Becker

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jennifer Jones	TELEPHONE: (323) 516-3833
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2