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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 07/03/2025
Date Signed: 07/03/2025 03:41:42 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
04/07/2025 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 11-AS-20250407120939
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: 110DATE:
07/03/2025
UNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH: Deeyanna Banda-Memory Care DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
#2 Allegation- Resident was sexually abused while in care
#3 Allegation- Staff did not properly report an incident involving a resident
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
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13
***This report supersedes the original report delivered on 06/23/2025. At 3:20 PM On 7/3/2025, the LPA arrived at the facility to deliver the corrected 9099, obtaining signatures of the authorized representative on the original report issued on 06/23/2025. *** Upon arrival Joseph Wieder was not avaliable to sign the report and Deeyanna Banda memory care director was authorized to sign.

On 6/23/2025, at 11:15 AM, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to deliver findings for the alleged allegation. LPA identified herself and met Brittany Kavanaugh-Administrator who was informed of the purpose of the visit.
The investigation consisted of the following:
On 04/15/2025 at 10:15 AM, LPA Allen obtained and reviewed files for Resident 1 (R1), which included face sheet, medical assessment dated 4/20/2025 , appraisal, needs and services plan, physicians report dated 2/7/2025, admissions agreement with personal property valuables list, staff and client roster dated April 2025, police report dated 4/6/2025 and UCLA Health after visit medical summery dated 4/6/2025, SOC341 and SIR 624 date 4/7/2025.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
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 2
Control Number 11-AS-20250407120939
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: 07/03/2025
NARRATIVE
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Investigation revealed the following:

#2 Allegation- Resident was sexually abused while in care

On 4/15/2025 LPA conducted interviews with staff members S1- S5 and 5 out of 5 staff members stated they did not witness or hear R1 being sexually abused by R2. Staff members stated when R1 was observed they only saw visible abrasions to their face and later that evening during their scheduled shower time R1 was observed with abdominal bruising which was reported. LPA interviewed R1, who stated they were not sexually assaulted by R2 only physically punched in their face and stomach.

LPA Allen also obtained and reviewed a copy of R1’s medical summary, which did not indicate any evidence of sexual assault. LPA Allen also interviewed W1, who stated upon arriving to the facility, both R1 and R2 were questioned, and R1 denied ever being sexually assaulted by R2.

LPA attempted to interview R2; however, R2 was not present at the facility during the investigation.

#3 Allegation- Staff did not properly report an incident involving a resident

On 4/15/2025, LPA conducted interviews with Staff 1- Staff 5 (S1 – S5) and 5 out of 5 staff members stated R1 was observed with visible abrasions to their face and body which was immediately reported, documented, and management was informed of the incident the same day. The police were also contacted the same day and upon their arrival both residents were interviewed and R2 admitted to physically assaulting R1 and they were taken into custody.

The Administrator- Brittany Kavanaugh and facility staff self- reported the incident by calling the police, completing the SOC341 and the Unusual incident report LIC624 and sent R1 to the hospital for assessment.

Based on the evidence gathered during the investigation, the above allegation is found to be Unsubstantiated; meaning that 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.


An exit interview was conducted where this report was discussed and provided to Deeyanna Banda at the conclusion of the visit with appeal rights. Per Administrators approval Deeyanna Banda was authorized to sign the report.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2