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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602264
Report Date: 08/24/2023
Date Signed: 08/28/2023 02:29:28 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
05/12/2023 and conducted by Evaluator Pamela Bunker
COMPLAINT CONTROL NUMBER: 11-AS-20230512082334
FACILITY NAME:TERRAZA COURTFACILITY NUMBER:
198602264
ADMINISTRATOR:GREG BECKERFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:115CENSUS: 64DATE:
08/24/2023
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Jasmine HezarTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not re-assess resident for change in level of care
Staff are not meeting residents bathing needs
Staff left residents in soiled diapers for an extended period of time
Staff are not feeding residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Thursday, 08/24/2023. 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 Jasmine Hezar. LPA Bunker explained the purpose of today's visit.The investigation consisted of the following: Interviews were conducted with staff members (S1-S2) and residents (R1-R6). LPA Bunker posed questions relevant to the nature of the complaint. Records of resident R1 were requested and reviewed by LPA Bunker. Both S1-S2 and R1-R6 confirmed that staff regularly reassesses residents for changes in their level of care. Additionally, both parties affirmed that staff meets residents' bathing needs adequately. It was also stated that residents are not left in soiled diapers for extended periods by both S1-S2 and R1-R6. S1-S2 mentioned that residents receive three meals daily along with snacks. LPA Bunker also requested copies of essential documents: resident roster, personnel report, formal declaration letters, monthly menu/meal plan, incontinence care policy, shower/bathing schedule, special incident reports, and staff's ongoing annual training. See continued LIC9099-C page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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 4
Control Number 11-AS-20230512082334
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: 08/24/2023
NARRATIVE
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Continued LIC9099-C page 2

Executive Director Hezar and LPA Bunker toured the facility it was clean, safe, sanitary, and in good repair at the time of the visit for the safety and well-being of clients, employees, and visitors. During today's visit, we observed residents eating breakfast and lunch.

Allegation #1: Staff did not re-assess resident for change in level of care
S1-S-2 and R1-R6 stated the facility staff does pre-admission appraisals and reassessments on residents if there are changes in any of their resident's levels of care. Staff will update residents' records in writing. If there are significant changes it is also noted by staff so that they can keep the appraisal accurate. If there are changes in the resident's physical, medical, mental, and social condition it is also documented. S1-S2 stated significant changes are reported immediately to their resident's physician, family, and responsible party. S1-S2 and R1-R6 stated they never witnessed any residents attacking any staff or residents. S1-S2 stated this is a zero-tolerance facility and physical abuse is prohibited. S1-S2 and R1-R6 denied the allegations

Allegation #2 Staff are not meeting residents bathing needs
S1-S2 and R1-R6 affirmed staff effectively meets residents' bathing needs. S1-S2 and R1-R6 stated staff assist residents with bathing and showers. Residents' personal hygiene has been met. During the visit, we did not observe any resident who appeared to be disheveled, the resident's hair, clothes, and appearance did not appear disordered. Residents were observed to be neat, clean, and well-groomed during today's visit. S1-S2 and R1-R6 denied the allegations

Allegation #3 Staff left residents in soiled diapers for an extended period of time
S1-S2 and R1-R6 interviewed stated that incontinent residents are checked every two (2) hours or as needed and during those times when they are known to be incontinent, during the morning, afternoon, day, and night. Staff stated incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. S1-S2 stated staff is receiving ongoing training on managing residents' incontinence. All residents interviewed stated they are never left in soiled diapers for any extended period of time. S1-S2 and R1-R6 denied the allegations

See continued LIC9099-C page 3
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20230512082334
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: 08/24/2023
NARRATIVE
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Continued LIC9099-C page 3

Allegation #4: Staff are not feeding residents
Based on interviews conducted with S1-S2 and R1-R2, it was ascertained that residents are provided with meals and a diverse range of food options. Both S1-S2 and R1-R6 confirmed that residents receive an ample quantity of food, including three (3) meals per day in addition to snacks - encompassing breakfast, lunch, dinner, and daily snacks. The food service staff is dedicated to serving well-balanced meals and offering a variety of food choices on a weekly basis. Notably, R1-R6 expressed satisfaction and reported no complaints regarding the quality of the food provided.

According to R1-R6, the food menu is updated on a weekly basis, allowing residents to opt for different selections if they so choose. S1-S2 and R1-R2 emphasized that there is a deliberate effort to avoid repetition in food offerings on a weekly basis.

During the assessment conducted by LPA Bunker, food menus from May 2023 through August 2023 were thoroughly reviewed. It was observed that each monthly menu featured a diverse array of food choices, corroborating the assertions made by S1-S2 and R1-R6. As a result of these findings, both S1-S2 and R1-R6 firmly refuted the allegations in question.

Investigation revealed the following: Staff 1-2 (1-2) and residents 1-6 (R2-R6) interviewed stated staff does re-assess residents for changes in level of care. S1-S2 stated if there are changes in a level of care residents' records are updated, in writing frequently. If there are significant changes it is also noted by staff so that they can keep the appraisal accurate. If there are changes in the resident's physical, medical, mental, and social condition it is documented. S1-S2 stated changes are reported to the resident's physician, family, and their responsible party immediately. S1-S2 and R1-R6 staff are meeting residents bathing needs. S1-S2 and R1-R6 stated staff assist residents with showering and bathing residents' hygiene are been met. During the visit, we did not observe any resident who appeared to be disheveled, the resident's hair, clothes, and appearance did not appear disordered. Residents were observed to be neat, clean, and well-groomed during today's visit. S1-S2 and R1-R6 stated residents are not left in soiled diapers for an extended period of time. S1-S2 and R1-R6 interviewed stated that incontinent residents are checked every two (2) hours or as needed, and during those times when they are known to be incontinent, during the morning, afternoon, day, and night. See continued LIC9099-C page 4
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20230512082334
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: 08/24/2023
NARRATIVE
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Continued LIC9099-C page 4

S1-S2 stated incontinent residents are checked during those periods of time when they are known to be incontinent. S1-S2 stated that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. S1-S2 stated staff is receiving ongoing training on managing residents' incontinence. S1-S2 stated residents are fed three meals a day plus snacks. R1-R6 stated residents are adequately fed and they are getting plenty of food to eat, three (3) meals per day plus snacks, breakfast, lunch, dinner, and snacks daily. The facility serves a well-balanced meal. The facility also provides alternative options, if residents don't want what's on the menu. R1-R6 stated the portions of food served are more than enough and they get plenty of food to eat and the staff will give them seconds. R1-R6 stated that they had no complaints about the food.

All residents interviewed stated they are treated with dignity and respect, and the staff cares about them. Residents stated that they are comfortable, the staff is providing the necessary care and supervision and their daily needs are being met. Residents interviewed stated they were happy at the facility and had no problems, issues, or concerns. Staff 1-2 (S1-S2) and residents 1-6 (R1-R6) 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.

There were no deficiencies cited.

Exit interview conducted.
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4