198603319-9-30-2024-11-AS-RORN-D9VQBS-20241009120201

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 08/30/2024
Date Signed: 09/30/2024 10:25:20 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 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
12/01/2023 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20231201104045

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:	DATE:	08/30/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Cesilia Torres.		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff do not treat residents with dignity or respect
Staff do not safeguard resident's personal items
Staff do not address resident behavior
Staff do not ensure that sharp objects are inaccessible to residents
Staff do not keep the facility free from cockroaches
Staff do not keep the facility free from bed bugs
Staff do not keep the facility clean and sanitary
Resident's door is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Friday, August 30, 2024. 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 Assistant Administrator Cesilia Torres. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: Interviews were conducted with staff members 1-3 (S1-S3), resident 1 (R1), and residents 3-7 (R3-R7). Resident 2 (R2) was unavailable for an interview after multiple attempts. S1-S3 stated that the resident's door was never broken on three occasions. Ms. Torres and LPA Bunker conducted an on-site tour. During today's visit, no sharp knives or hazardous items were accessible or visible, as they were stored in a locked kitchen cabinet. We did not observe any cigarette butts anywhere, nor were any cockroaches, bed bugs or lice discovered. We also inspected the door and doorknob of room #229. Ms. Torres successfully unlocked the door using the facility's master key, and the resident of room #229 demonstrated the ability to unlock the door with R1's personal key. See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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-20231201104045

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/30/2024

NARRATIVE

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Continued LIC9099-C page 2

These tests confirmed that the doorknob in room #229 can be unlocked and is fully functional and in good repair. The overall condition of the facility was evaluated as clean, safe, sanitary, and well-maintained. LPA Bunker requested copies of supporting documents.

Allegation #1 Staff do not treat residents with dignity or respect
Interviews were conducted with staff members 1-3 (S1-S3) and residents 3-7 (R3-R7). They all stated that the staff always treated residents with dignity and respect and that the staff did not disrespect any residents. S1-S3 and R3-R7 stated staff does not scream and yell at residents, staff ensures residents are safe, healthy, and in a comfortable environment, and that residents' daily needs are met. R1 stated that the staff screams and yells at residents. R2 was not available for an interview. S1-S3 stated they do their best to keep residents free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other punitive actions that may interfere with their daily living functions. S1-S3 and R3-R7 denied the allegation.

Allegation #2 Staff do not safeguard resident's personal items
Interviews were conducted with staff members 1-3 (S1-S3) and residents 3-7 (R3-R7), states staff does safeguard resident's personal items and mail. R1 stated staff stole mail and personal items. S1-S3 stated that R1 stole and was caught on camera stealing from staff and other residents. S1-S3 stated the police came to the facility looking for R1 because the neighbors reported that R1 was stealing in the neighborhood. R1 would not allow the police officers inside the room to do a search. S1-S3 stated staff safeguarded residents' personal belongings in accordance with Title 22 Regulations. S1-S3 and R3-R7 denied the allegation.

Allegation #3 Staff do not address resident behavior
Interviews were conducted with staff members 1-3 (S1-S3) and residents 3-7 (R3-R7),
stated staff does address resident behavior. S1-S3 states if there is a concern they will address the problem immediately. They do everything they can to resolve any issues that occur and a resident is having. S1-S-3 and R3-R7 denied the allegation.

See continued LIC9099-C page 3

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 11-AS-20231201104045

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/30/2024

NARRATIVE

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Continued LIC9099-C page 3

Allegation #4 Staff do not ensure that sharp objects are inaccessible to residents
Interviews were conducted with staff members 1-3 (S1-S3) and residents 3-7 (R3-R7), who stated staff does ensure that sharp objects are inaccessible to residents. S1-S3 and R3-R7 stated they did not witness any resident being chased with a knife. R2 was unavailable for an interview. R2 was out in the community. S1-S3 stated that the staff ensures that care and supervision are met to meet residents' needs. S1-S3, R1, and R3-R7 denied the allegation

Allegation #5 Staff do not keep the facility free from cockroaches
LPA interviewed S1-S3 and R3-R7 who stated that the facility did not have any cockroaches. S1-S3 and R3-R7 stated that the facility has a pest control company that provides ongoing pest control treatment to the facility. S1-S3 and R3-R7 stated that an exterminator comes out to the facility regularly to ensure that the facility is free from cockroaches. R2 was not available for an interview. R2 was out in the community. Based on the records review, a record of pest control services are conducted 2 times a month by Enviroworx Pest Control and more if needed LPA did not observe cockroaches in the facility during today's visit. S1-S3 and R3-R7 denied the allegation.

Allegation #6 Staff do not keep the facility free from bed bugs
LPA interviewed S1-S3 and R3-R7 who stated that the facility had bed bugs in the past. The facility no longer has any bed bugs. S1-S3 and R3-R7 stated that the facility has a pest control company that provides ongoing pest control treatment to the facility, and the exterminator comes to the facility to ensure that the facility is free from bed bugs. R2 was not available for an interview. R2 was out in the community. Based on the records review, a record of pest control services is conducted 2 times a month by Enviroworx Pest Control and more if needed. LPA did not observe any bed bugs in the facility during today's visit. S1-S3 and R3-R7 denied the allegation.

Allegation #7 Staff do not keep the facility clean and sanitary
LPA interviewed S1-S3 and R3-R7 who stated that housekeeping keeps the facility clean and sanitary at all times. S1-S3 and R3-R7 stated housekeeping cleans the facility every day. S1-S3 and R3-R7 stated the facility is clean, safe, sanitary, and in good repair at all times for the safety and well-being of clients, employees, and visitors. See continued LIC9099-C page 4

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20231201104045

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BEVERLY HILLS TERRACE	FACILITY NUMBER: 198603319
	VISIT DATE: 08/30/2024

NARRATIVE

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Continued LIC9099-C page 4

S1-S3 stated the facility staff take every measure to keep the facility free of cockroaches, bed bugs, flies, and other insects. S1-S3 and R3-R7 denied the allegation.

Allegation #8 Resident's door is in disrepair. LPA interviewed S1-S3 and R3-R7, who all stated that the resident's door was not in disrepair. S1-S3 stated residents' bedroom doors and doorknobs are in working and operable condition. S1 and LPA Bunker toured seven resident bedrooms 108, 111, 113, 114, 115, 201, 215, 218, 219, 222, 228, and 229. During the tour, S1 and S2 checked the resident bedroom doorknobs, all doors were functioning properly. The door and doorknobs were found to be in working order in all resident rooms. R1 stated that R2 knocked on her door and broke the doorknob. S1-S3 and R3-R7 denied that the resident's door was in disrepair.

Investigation revealed the following: Investigation revealed the following: Interviews with staff members 1-3 (S1-S3) and residents 3-7 (R3-R7) revealed that staff treat all residents with dignity and respect. S1-S3 stated that R1 frequently reported items as stolen or missing. However, after facility investigations, it was discovered that R1 was the individual caught stealing. S1-S3 stated that R1 was captured on camera stealing from the basement, as well as from both staff and other residents. S1-S3 explained that each resident is provided with a single cabinet secured by a padlock to enhance security and protect their valuable assets or confidential documents. R3-R7 stated that staff safeguard residents' personal belongings. S1-S3 and R3-R7 stated that staff appropriately address any aggressive behavior from residents, and sharp objects are kept inaccessible to them. S1-S3 and R3-R7 also stated that the facility does not have any cockroach or bed bug infestations. S1 provided copies of invoices from Enviroworx Pest Control and Orkin, confirming that the facility is free of insects, cockroaches, and bed bugs. S1-S3 and R3-R7 stated that the facility is clean, safe, sanitary, and well-maintained. S1-S3 mentioned that staff take every measure to keep the facility free of flies and other insects. S1-S3 stated that residents' bedroom doorknobs were in working and operable condition, and all doors were functioning properly. S1-S3 and R3-R7 stated that any problems the facility encounters are addressed and resolved immediately. If there were any issues, S1-S3 stated that staff would have reported them to the appropriate agencies in a timely manner. During today’s visit, no problems were observed, and the doorknobs were found to be in good condition. S1-S3 and R3-R7 all 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. A copy of the Complaint Investigation Report LIC9099, and LIC9099-C, was provided to Assistant Administrator Cesilia Torres. There were no deficiencies cited.
Exit interview conducted.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC9099 (FAS) - (06/04)

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