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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:04:58 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
10/23/2024 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20241023104859
FACILITY NAME:BEVERLY HILLS TERRACEFACILITY NUMBER:
198603319
ADMINISTRATOR:STRIKS, AHARONFACILITY TYPE:
740
ADDRESS:1470 S ROBERTSON BLVDTELEPHONE:
(310) 273-3668
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:110CENSUS: 58DATE:
10/30/2024
UNANNOUNCEDTIME BEGAN:
09:53 AM
MET WITH:Administrator Ella NaygasTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are not safeguarding resident's personal possessions.
INVESTIGATION FINDINGS:
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On 10/30/24 Licensing program analyst (LPA) Villegas conducted an initial complaint visit regarding the allegations above. LPA met with Administrator Ella Naygas as the purpose of today's visit was explained.

The investigation consisted of the following: On 10/30/24 LPA obtain copies of the staff and client rosters, and obtained the following documents for resident 1 (R1): Emergency ID form,admission agreement dated 04/11/23,MAR for October 2024, physicians report dated: 03/12/23 ,needs and service plan dated 03/08/24, preplacement appraisal 02/08/24, appraisal 02/08/24, telecommunication device notification dated 04/11/23, client personal property and valuables dated and signed 04/11/23, copies of (2) 30 day eviction notices that were sent to CCLD on 07/26/24 and 09/18/24. On 10/30/24 LPA conducted a tour of the facility and there are no immediate health and safety concerns. On 10/30/24 between 9:30 am- 11:30am LPA conducted interviews with clients 1-6 (C1-C6), and between 11:35am- 1:30pm interviews were conducted with staff 1-4 (S1-S4).

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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 2
Control Number 11-AS-20241023104859
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: 10/30/2024
NARRATIVE
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The investigation revealed the following:

Allegation: Staff are not safeguarding resident's personal possessions.
It is being alleged that Lifeline tablets and phones are stolen from C1. On 10/30/24 between 11:35am- 1:30pm LPA interviewed S1 regarding the allegation above, S1 denied the allegation above and reported safeguarding is part of the admission agreement however clients or clients responsible party can refuse to complete the safeguard document. On 10/30/24 between 11:35am- 1:30pm LPA conducted interviews with S2-S4, 3 of 3 staff interviewed denied the allegation above. On 10/30/24 between 9:30 am- 11:30am LPA conducted interviews with C1, C1 denied the allegation above, and reported having cellphone in C1's possession. LPA observed C1 to have (2) cellphones at the time of interview. On 10/30/24 between 9:30 am- 11:30am LPA conducted interviews with C2-C6, 3 of 5 clients interviewed denied the allegation above, 1 of 5 clients interviewed confirmed the allegation above, and 1 of 5 clients interviewed reported being admitted into the facility with no property nor valuables.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted with Administrator Ella Naygas, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC9099 (FAS) - (06/04)
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