198603319-2-28-2021-11-AS-MVAO-BYQPWZ-20210302104134

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 02/26/2021
Date Signed: 02/28/2021 11:24:05 AM

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
01/07/2021 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210107141009

FACILITY NAME:	BEVERLY HILLS TERRACE		FACILITY NUMBER:	198603319
ADMINISTRATOR:	STRIKS, AHARON		FACILITY TYPE:	740
ADDRESS:	1470 S ROBERTSON BLVD		TELEPHONE:	(818) 293-2007
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	110	CENSUS: 89	DATE:	02/26/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Clifford Johnson, Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff is taking money from resident's account

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to deliver findings and decisions for the allegation listed above. Due to the situation surrounding the Corona virus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Clifford Johnson, the facility administrator.

The investigation consisted of following: Interviews, virtual tour of the office, and Record reviews. On 01/11/21 & 02/23/21, LPA Soto interviewed Administrator, Ella Nagas. On 02/23/21, LPA Soto interviewed Administrator Clifford Johnson, R#1 – R#9, S#2 – S#7. LPA Soto obtained the following documents: Face sheets, Pre-Appraisals, Physician's Report, Incident reports, Safeguard Cash resources, Resident roster, and Staff rosters.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

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-20210107141009

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: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 02/26/2021

NARRATIVE

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Based on the LPA's investigation, the investigation revealed the following. For Allegation –Staff is taking money from resident's account. The interviews conducted with R#1 – R#9, stated that none of the residents had ever had their money taken by the staff. Interviews conducted with staff, stated that they had never taken money from any residents. The Administrators Ella and Clifford also stated that they had never taken money from any resident. LPA Soto reviewed the safeguard Cash resources for all residents, there were no discrepancies, the residents received all their money every month. The interviews conducted and documents obtained did not concur with the above 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 unsubstantiated

A tele-visit exit interview was conducted with Clifford Johnson, Administrator, and a hard copy was provided via email for signature.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021

LIC9099 (FAS) - (06/04)

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