198603319-10-17-2025-11-AS-EMAZ-DRT278-20260302160817

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 10/17/2025
Date Signed: 10/17/2025 01:06:33 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
03/24/2025 and conducted by Evaluator Troy Watson

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250324094301

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: 61	DATE:	10/17/2025
		UNANNOUNCED	TIME BEGAN:	08:48 AM
MET WITH:	YESENIA ROBLES-MARKET/CARE GIVER		TIME COMPLETED:	01:10 PM

ALLEGATION(S):

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Staff did not prevent a resident from developing pressure injuries.
Staff do not ensure that residents' dietary needs are met.
Staff do not observe residents for change in condition.
Staff did not assist resident with grooming
Staff do not maintain facility sanitary

INVESTIGATION FINDINGS:

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On 10/17/2025 LPA Watson conducted a subsequent complaint visit to deliver findings to the facility listed above. LPA met with the Marketing/Care Giver Yesenia Robles, and the purpose of today’s visit was explained. LPA was given access to the facility.

The investigation consisted of the following:

On 10/16/2025 Licensing Program Analyst (LPA) Watson requested, reviewed, and obtained copies of the Staff Roster, Client Roster, On 10/17/2025 LPA Watson requested and obtained the following documentatin : Admission Agreement, Physicians Report, Appraisal Needs and Services and Monthly Menu Plan. On10/16/2025 LPA Watson conducted interviews with Staff #1-Staff #6 (S1-S6) and Residents #2- Residents #7 (R2-R7).

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025

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-20250324094301

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: 10/17/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not prevent a resident from developing pressure injuries.

On 10/16/2025 LPA Watson conducted interviews with Residents #2- Residents #7 (R2-R7). An attempt to interview Resident #1 (R1) was made but R1 was not at the facility at the time of the visit.LPA Watson asked the residents if staff neglected to prevent them from developing pressure injuries. Of those interviewed, 6 out of 7 residents denied the above allegation. On 10/16/2025 LPA Watson interviewed Staff #1- Staff #6 (S1-S6). LPA Watson asked the staff if they met the residents’ dietary needs. Of those interviewed, 6 out of 6 staff denied the above allegation. On 10/17/2052, LPA Watson requested documentation and incident reports, from the on duty nurse and staff interviewed, and found that there was no documented evidence of pressure injuries developed by the resident in care. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

Allegation: Staff do not ensure that residents' dietary needs are met.

On 10/16/2025 LPA Watson conducted interviews with Residents #2- Residents #7 (R2-R7). An attempt to interview Resident #1 (R1) was made but R1 was not at the facility at the time of the visit. LPA Watson asked each resident interviewed if staff did not ensure their dietary needs were met. Of those interviewed, 6 out of 7 residents denied the above allegation. On 10/16/2025 LPA Watson interviewed Staff #1- Staff #6 (S1-S6). LPA Watson asked the staff if they assisted residents with their dietary needs. Of those interviewed, 6 out of 6 staff denied the above allegation. On 10/17/25 LPA Watson requested, obtained and reviewed the weekly menu plan from the facility and it showed that the resident in question was offered three meals a day plus snacks. Based on the information gathered, interviews conducted, and review of records LPA Watson found no evidence to support the allegation mentioned above. 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.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250324094301

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: 10/17/2025

NARRATIVE

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Allegation: Staff do not observe residents for change in conditions.

On 10/16/2025 LPA Watson conducted interviews with Residents #2- Residents #7 (R2- R7). An attempt to interview Resident #1 (R1) was made but R1 was not at the facility at the time of the visit. LPA Watson asked the residents if staff monitored them for any change in conditions. Of those interviewed, 6 out of 7 residents interviewed denied the above allegation. On 10/16/2025 LPA Watson asked the staff if they observed residents for change in conditions. 6 out of 6 staff interviewed denied the above allegation. LPA Watson requested, obtained and reviewed staff log notes and found that there was no documented evidence of changes in conditions about the residents. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

Allegation: Staff did not assist residents with grooming.

On 10/16/2025 LPA Watson conducted interviews with Residents #2- Residents #7 (R2-R7). LPA Watson asked the residents if staff neglected to assist them with their grooming. An attempt to interview Resident #1 (R1) was made but R1 was not at the facility at the time of the visit. Of those interviewed, 6 out of 7 residents denied the above allegation. On 10/16/2025 LPA Watson interviewed Staff #1- Staff #6 (S1-S6). LPA Watson asked the staff if they assisted residents with their grooming needs. Of those interviewed, 6 out of 6 staff denied the above allegation. LPA Watson interviewed 6 staff members and 6 residents and all of those interviewed stated that staff assisted residents with grooming. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250324094301

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: 10/17/2025

NARRATIVE

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Allegation: Staff do not maintain sanitary facilities.

On 10/16/2025 LPA Watson conducted interviews with Residents #2- Residents #7 (R2-R7). An attempt to interview Resident #1 (R1) was made but R1 was not at the facility at the time of the visit. LPA Watson asked the residents if staff maintained the facility to be sanitary. Of those interviewed, 6 out of 7 denied the above allegation. On 10/16/2025 LPA Watson interviewed Staff #1- Staff #6 (S1-S6). LPA Watson asked the staff if they maintained the facility clean and sanitary. Of those interviewed, 6 out of 6 denied the above allegation. LPA Watson conducted a tour of the facility and found the facility to be clean and in good repair. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

An exit interview was conducted with the Marketing / Care Giver Yesenia Robles and a copy of this report was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025

LIC9099 (FAS) - (06/04)

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