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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 06/13/2025
Date Signed: 06/13/2025 11:51:52 AM

Unfounded


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
06/06/2025 and conducted by Evaluator Deborah Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250606170327
FACILITY NAME:TERRAZA COURT SENIOR LIVINGFACILITY NUMBER:
198320456
ADMINISTRATOR:KAVANAUGH, BRITTANYFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:170CENSUS: 107DATE:
06/13/2025
UNANNOUNCEDTIME BEGAN:
08:39 AM
MET WITH:Deeyanna Banda, Memory Care DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Resident fell while in care due to staff neglect.
Staff did not respond to resident's requests for assistance in a timely manner.
Staff are not feeding resident food according to their special diet/restrictions.
Staff mismanage resident's medications.
INVESTIGATION FINDINGS:
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On June 13, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted a complaint visit regarding the above allegations. LPA Lee met with Brittany Kavanaugh, Executive Didrector, and Deeyanna Banda Memory Care Director and explained the reason for the visit.

The investigation consisted of the following:
On June 13, 2025, LPA obtained and reviewed Resident Rosters (dated 1/1/25-6/13/2025), staff roster (no date). LPA conducted interviews with 4 staff including Executive Director (A1, S1-S3).

The investigation revealed the following:


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Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2025
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 3
Control Number 11-AS-20250606170327
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: TERRAZA COURT SENIOR LIVING
FACILITY NUMBER: 198320456
VISIT DATE: 06/13/2025
NARRATIVE
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Allegations:

Resident fell while in care due to staff neglect.
Staff did not respond to resident's requests for assistance in a timely manner.
Staff are not feeding resident food according to their special diet/restrictions.
Staff mismanage resident's medications

The complaint alleges the following: On Sunday before Memorial Day, R1 fell off of the toilet because staff took too long to respond to R1’s call for assistance, R1 pulled the emergency “lever” [call button], but staff didn’t respond for two hours, the facility does not adhere to R1’s dietary preferences/restrictions and the facility did not refill R1’s medication when it ran out.

On 6/13/25 between 8:42am-10:00am LPA conducted interviews with Deeyanna Banda, Memory Care Director (A1), and Brittany Kavanaugh Executive Director (S1) who denied the allegations stating that R1 is not a resident of the facility and has never been a resident of the facility. Additionally, LPA interviewed S2-S3 regarding the allegations and they also denied the allegations stating that R1 is not a resident of the facility.

On 6/13/25, LPA obtained/reviewed staff rosters dated (1/1/25-6/13/25) and R1's name was not listed on either roster which corroborated staff's report that R1 is not nor has been a resident of the facility.

This agency has investigated the complaint alleging: Resident fell while in care due to staff neglect; Staff did not respond to resident's requests for assistance in a timely manner; Staff are not feeding resident food according to their special diet/restrictions; and Staff mismanage resident's medications.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20250606170327
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: TERRAZA COURT SENIOR LIVING
FACILITY NUMBER: 198320456
VISIT DATE: 06/13/2025
NARRATIVE
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We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint

No deficiencies cited during today's visit

Exit interview conducted and copy of report provided to Deeyanna Banda, Memory Care Director.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2025
LIC9099 (FAS) - (06/04)
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