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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602264
Report Date: 09/09/2024
Date Signed: 09/09/2024 06:34:59 PM


Document Has Been Signed on 09/09/2024 06:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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



FACILITY NAME:TERRAZA COURTFACILITY NUMBER:
198602264
ADMINISTRATOR:HEZAR, JASMINEFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:170CENSUS: 73DATE:
09/09/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
05:18 PM
MET WITH:Wellness Director Michelle BrownTIME COMPLETED:
06:40 PM
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On 09/09/24, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced case management - health and safety check at the facility mentioned above. LPA met with Wellness Director Michelle Brown and explained the purpose of the visit. Wellness Director and LPA toured the first floor, second floor, and memory care (first floor). LPA Cloyd observed that the first floor entryway was cool, the dining room had a running air conditioner, and activity room's thermostat reflected 78 degrees Fahrenheit. LPA observed that the hallways in the Memory Care unit was warm. Wellness Director and LPA was unable to locate the thermostat for the Memory Care unit during the tour. At 6:18 PM, Wellness Director indicated that the thermostat on the second floor regulates the hallway temperature in Memory Care. LPA observed air conditioners in the activity and dining room in Memory Care. The Executive Director Brittany Kavanaugh indicated that the caregivers assist with turning the air conditioners on and off in the residents' bedrooms in Memory Care. LPA inspected rooms 130 and 139 in the Memory Care unit and the air conditioners are functioning. Wellness Director and LPA toured the second floor and inspected rooms 209, 224, and 245. Each room has a functioning air conditioner. The thermostat near room 245 reflected 82 degree Fahrenheit. Wellness Director indicated that the facility monitors the thermostat every hour.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview with the Executive Direcor Brittany Kavanaugh over the phone was conducted and a copy of this report was provided to the Wellness Director Michelle Brown.
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina CloydTELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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