198603319-8-3-2024-11-AS-JHAD-D7UP7A-20240805110336

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 08/03/2024
Date Signed: 08/03/2024 04:48:44 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/08/2024 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240708123811

FACILITY NAME:	BEVERLY HILLS TERRACE		FACILITY NUMBER:	198603319
ADMINISTRATOR:	STRIKS, AHARON		FACILITY TYPE:	740
ADDRESS:	1470 S ROBERTSON BLVD		TELEPHONE:	(310) 273-3668
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	110	CENSUS: 68	DATE:	08/03/2024
		UNANNOUNCED	TIME BEGAN:	09:38 AM
MET WITH:	Ella Naygas		TIME COMPLETED:	10:47 AM

ALLEGATION(S):

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Resident does not have access to room.
Staff did not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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On 08/02/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted a subsequent unannounced visit at this facility. LPA was greeted by the Administrato Ella Naygas. LPA explained the purpose of this visit was to deliver findings for the allegations mentioned above.

The investigation consisted of the following: A copy of the facility's roster for residents and staff, service records for resident #1 (R1) Physician Report LIC 602A (dated: 03/12/24), Appraisal/Needs and Services Plan (dated: 03/08/24), and Unusual Incident Report LIC 624 (dated: 05/30/24 and 05/31/24), Physician’s Orders Medications List (dated: 07/07/24 - 08/06/24), and other records associated with this complaint. Interviews with residents #1-10 (R1-R10) and assistant administrator #1 (A1) and staff #1-#2 (S1-S2). A plant inspection of the facility of room #218 and the common areas.

(Evaluation Report continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2024

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-20240708123811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/03/2024

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation #1: Resident does not have access to room.
In the complaint, it was alleged that resident #1 (R1) does not have access to (R1’s) room. The complainant stated that (R1) is not issued a key and that staff must give entry to (R1). The complainant did not provide further information about this matter.

Investigation revealed resident #1 (R1) came from Sunray Healthcare Center. According to resident #1 (R1’s) Identification and Emergency Information LIC 601 (dated: 04/11/23), (R1) was admitted to Beverly Hills Terrance on 04/10/23.

On 07/11/24, between 10:15 am - 01:00 pm, the Department interviewed (10) out of (10) residents #1 - #10 (R1-R10) who denied having issues accessing their room. (R1-R10) claimed they had been given a room key and disclosed the room numbers. (R1) stated the staff has never denied (R1) access to (R1’s) room. (R2-R10) claimed they had not observed any residents who were not issued a room key or were aware of residents not having a key and must be escorted to a room by staff. (R3-R10) praised the facility staff and mentioned they were responsive to their care and supervision.

On 07/11/24, between 09:30 am – 01:30 pm, the Department interviewed assistant administrator #1 (A1), and staff #1 (S1) claimed this allegation was false. (A1-S1) stated that (R1) spends limited time inside the facility and spends most of the time out in the community to engage with other residents or be involved in any activities. (A1) explained that (R1) has been a resident for over a year, and during (R1's) residency, (R1) has misplaced or lost (R1’s) key several times. (A1) stated (R1) has never denied access to (R1’s) room and has been given a duplicate room key to access (R1’s) room. (A1-S1) claimed when they were seen (R1) did not have access to (R1’s) room. (A1-S1) stated that (R1) will occasionally refuse medication and behave disorderly if medication has not been taken.

On 07/15/24, between 10:17 am – 10:45 am, the Department interviewed (1) out of (1) staff #2 who verified (R1) always has access to (R1’s) room. (S2) had intervened in an incident between (R1) and (R2) on 05/31/24. (S2) recalled intervening in a heated situation between (R1) and (R2) where (R1) was the integrator. (R1) was escorted to (R1’s) room while (S2) dispatched for additional staff assistance. (S2) reported when (R1) was escorted to (R1’s) room, (R1) had a key to unlock the room door. Based on the gathered information, there is no evidence to support the allegation mentioned above.

(Evaluation Report continues LIC 9099-C)

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240708123811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/03/2024

NARRATIVE

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Allegation #2: Staff did not safeguard resident's personal belongings.
It is alleged resident #1 (R1’s) personal belongings are not safeguarded by the facility staff. The complainant reported there had been a theft from (R1’s) room and clothing had been damaged. The complainant did not provide further details on this matter.

On 07/11/24, between 10:15 am - 01:00 pm, the Department interviewed (10) out of (10) residents #1 - #10 (R1-R10) denied having issues or concerns with their personal belongings safeguarded while a resident at this facility. Three (3) out of ten (10) residents claimed in the past they had some items missing or stolen from their room, but stated it is their carelessness for leaving their door ajar or unlocked. (R1) stated in the past some clothing had gone missing or was damaged but could not provide further details for clarification.

On 07/11/24, between 09:30 am – 01:30 pm, the Department interviewed assistant administrator #1 (A1) and staff #1 (S1) claimed this allegation was untrue. (A1-S1) stated since (R1) spends the majority of (R1’s) time out in the community, the room is always empty. Only (R1) and management have access to (R1’s) room. (R1) has not reported any items stolen, missing, or damaged in (R1’s) room. (A1-S1) reported that (R1) has a history of misplaced/or lost room keys, so it is no surprise that (R1) would also assume that personal items are missing or lost as well. (A1) stated residents are given one cabinet with a padlock to fortify security to safeguard valuable assets or confidential documents. (A1-S1) stated that (R1) has two (2) padlock cabinets in (R1’s) room for convenience and security. (A1-S1) stated that (R1) is in a private room and the only resident that has access to (R1's) room. The facility does not do (R1's) laundry as (R1's) preference own washing and drying of clothes.

On 07/15/24, between 10:17 am – 10:45 am, the Department interviewed (1) out of (1) staff #2 who indicated is unaware of any missing personal items taken from (R1’s) room. (S2) stated (R1) has not reported any personal belongings missing from (R1’s) room. (S2) explained that (R1’s) valuable items are in padlocked cabinets and that (R1) is the only one with a key. (S2) confirmed that (R1) has two (2) padlock cabinets that (R1) utilizes.

On 07/11/24, between 01:30 pm – 01:59 pm, the Department inspected (R1’s) room #218 and observed two sides by side four (4) drawer dressers filled with clothes, multiple clothes piled on two (2) chairs, several clothes hanging on a bathroom towel rack and two (2) cabinets with two (2) padlocks shackled on each cabinet. (Evaluation Report continues LIC 9099-C)

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240708123811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/03/2024

NARRATIVE

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The Department identified the facility had surveillance cameras installed in the common areas for safety, security, and monitoring.

As a result of the Department reviewing (R1’s) Physician Report LIC 602A (dated: 03/12/24), Appraisal/Needs and Services Plan (dated: 03/08/24), and Unusual Incident Report LIC 624 (dated: 05/30/24 and 05/31/24) verified (R1) is evaluated with a history of mental illness. A review of (R1’s) Physician’s Orders Medications List (dated: 07/07/24 - 08/06/24), revealed (R1) is on (11) routine medications. Six (6) out of eleven (11) prescribed medications have side effects on mental health according to the National Institute of Health (ref: NIH). Based on the gathered information, there is no evidence to support the allegation mentioned above.

Based on the information collected, an inspection of the facility, observation and interviews conducted, and an analysis of records reviewed, the Department found no evidence to support the allegations mentioned in this complaint. 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 allegations are Unsubstantiated.

An exit interview is conducted with Ella Naygas, and a copy of the report is provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2024

LIC9099 (FAS) - (06/04)

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