198602264-7-21-2023-11-AS-MVAO-CUDUQZ-20230804154758

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 07/21/2023
Date Signed: 07/21/2023 01:58:05 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
06/26/2023 and conducted by Evaluator Alfonso Iniguez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230626114958

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: 58	DATE:	07/21/2023
		UNANNOUNCED	TIME BEGAN:	09:28 AM
MET WITH:	Jasmin Hezar-Executive Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facilty fails to serve Residents nutrionally well-balanced meals
Facility AC is not in good repair
Facility fails to provide new care staff training

INVESTIGATION FINDINGS:

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On 7/21/2023 LPA Alfonso Iniguez conducted and unannounced complaint visit. LPA Iniguez meet with Jazmin Hezar/Administrator. LPA explained the purpose of this visit.

Investigation Consisted of: LPA conducted interviews with Resident (R#1-R#6), Administrator(A#1), and Staff (S#1-S#6). LPA obtained and reviewed facility weekly menu, safe serve certification from cook and kitchen staff, physical tour of the facility including the kitchen pantry and refrigerator, 7 residents’ rooms and 6 new staff training materials, resident roster and staff roster.

Evaluation Report continues LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20230626114958

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TERRAZA COURT	FACILITY NUMBER: 198602264
	VISIT DATE: 07/21/2023

NARRATIVE

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Investigation Revealed the Following:

Allegation: Facility fails to serve Residents nutritionally well-balanced meals

The details of the complaint alleged that the facility does not have a chef and does not serve nutritional meals.

During the records review and physical tour, LPA observed food service, kitchen, and food supply. During this investigation, LPA reviewed the weekly menu. LPA observed meal selections were meeting the requirement of 1/3 of the servings recommended in the USDA Basic Food Group Plan. In addition, LPA reviewed kitchen staff safe serve certification, facility weekly menus, and kitchen pantry and refrigerator, and everything followed Tittle 22 guidelines on food service. During interviews with residents (R#1-R#6), 6 out of 6 stated the facility serves well-balanced nutritious meals. During interviews with staff (S#1-S#6), 5 out of 6 staff felt that the meals were nutritious and well-balanced.

Allegation: Facility AC is not in good repair
The details of the complaint alleged that the facility's air conditioning unit was not working.

During the facility tour, LPA checked the facility's temperature using a thermometer; the reading in the thermometer marked (74.5F), never reached above (85.0F) degrees inside the facility. In addition, LPA checked 7 resident’s rooms, and the AC unit was working correctly in all of them. LPA Iniguez also interviewed Facility Administrator Jazmin Hezar (A#1). (A#1) stated that the facility's Air Conditioning Unit is working properly and has never stopped working; only one area of the facility is not working. During interviews with residents (R#1- R#6), 6 out of 6 stated the temperature was comfortable in the facility, and their AC unit was working correctly. During interviews with staff (S#1-S#6), 6 out of 6 said the AC units in the facility and residents' rooms are working correctly.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 11-AS-20230626114958

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TERRAZA COURT	FACILITY NUMBER: 198602264
	VISIT DATE: 07/21/2023

NARRATIVE

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Allegation: Facility fails to provide new care staff training

The details of the complaint alleged that new staff working in the facility are not adequately trained. During the records review, LPA Iniguez inspected a total of 8 employee personnel files. The record review included auditing management, office, kitchen, and care staff. During interviews with the executive director Jasmin Hezar (A#1), she stated that newly hired staff gets trained in an online portal called Relias Onboarding. This portal is tailored to staff hired to work at an RCFE. During interviews with staff (S#1-S#6), 5 out of 6 staff mentioned they get trained monthly. During interviews with residents (R#1-R#6), 5 out of 6 residents responded the staff is trained and they feel safe.

During this investigation, LPA did not find sufficient evident to support the above-mentioned allegations.

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegations are found to be UNSUBSTANTIATED.

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

California Code of Regulations (Title 22, Division 6, Chapter 8).

An exit interview was conducted, and a copy of the Complaint Report was given to Jasmin Hezar/Executive Director.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023

LIC9099 (FAS) - (06/04)

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