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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 11/07/2024
Date Signed: 11/07/2024 02:41:58 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
11/01/2024 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20241101103650
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: DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
08:51 AM
MET WITH:Administrator Ella NaygasTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff did not prevent resident from being sexually abused by other residents.
Staff are serving contaminated food to residents in care.
Staff does not ensure residents are spoken to in an appropriate manner.
Staff are over medicating resident.
INVESTIGATION FINDINGS:
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On 11/07/24 Licensing program analyst (LPA) Villegas conducted a subsequent complaint visit to deliver findings. LPA met with Administrator Ella as the purpose of today's visit was explained.
The investigation consisted of the following: On 11/04/24 LPA obtain copies of the staff and resident rosters, pertinent documents to the complaint for Resident #1, and a copy of the menu for the month of November 2024. On 11/04/24 LPA conducted a tour of the facility kitchen and there are no immediate health and safety concerns. On 11/04/24 between 9:48 am- 12:30am LPA conducted interviews with residents #1-6 (R1-R6), and between 12:30pm-1:30 pm interviews were conducted with staff 1-3 (S1-S3). On 11/07/24 LPA conducted interview with Administrator (A1).

The investigation revealed the following:
Allegation: Staff did not prevent resident from being sexually abused by other residents.
It is being alleged that several male residents on the same floor as R1 are sexually harassing R1 every day. On 11/07/24 LPA conducted interview with A1 regrading the allegation above, A1 denied the
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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 3
Control Number 11-AS-20241101103650
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: 11/07/2024
NARRATIVE
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allegation above and reported the facility has not experienced sexual abuse allegations prior to this one. Per A1, staff will investigated allegation, and report the allegation to CCLD if and when abuse is reported by a resident in care. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interview with R1 regarding the allegation above, R1 reports being assaulted by (2) male residents on September 8th, 2024. Per R1, R1 did not report the assault to staff however R1 called LAPD to make a report. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interviews with residents #2-6 (R2-R6) regarding the allegation above, 5 of 5 residents interviewed denied the allegation above. On 11/04/24 between 12:30pm-1:30 pm LPA conducted interviews with staff 1-3 (S1-S3) regarding the allegation above, 3 of 3 staff interviewed denied the allegation above. On 11/04/24 LPA reviewed UCLA health ER discharge summary dated 09/07/24, there was no indication of sexual assault. On 11/04/24 LPA reviewed the incident report submitted to CCLD on 09/07/24 regarding the allegation above.

Allegation: Staff are serving contaminated food to residents in care

It is being alleged that the food being serve tastes bad and makes R1 feel sick when R1 consumes it. On 11/07/24 LPA conducted interview with A1 regarding the allegation above, A1 denied the allegation above and reported that the facility has a dietician who visits and inspects the kitchen and menu every month. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interview with R1 regarding the allegation above, R1 states R1 becomes dizzy and nauseous when drinking the cherry juice from the container and believes the drug dealers from down the street are putting PCP into the juice. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interviews with residents #2-6 (R2-R6) regarding the allegation above, 4 of 5 residents interviewed denied the allegation above, 1 of 5 residents interviewed sates the yogurt and milk is sometimes sour. On 11/04/24 between 12:30pm-1:30 pm LPA conducted interviews with staff 1-3 (S1-S3) regarding the allegation above, 3 of 3 staff interviewed denied the allegation above. On 11/04/24 LPA conducted tour of the facility kitchen, LPA observed pantry to have expiration dates on can goods, kitchen was clean and organized at the time of visit.

Allegation: Staff does not ensure residents are spoken to in an appropriate manner

It is being alleged that the facility administrator is rude to and yells at residents. On 11/07/24 LPA conducted interview with A1 regarding the allegation above, A1 denied the allegation above and reported staff have to speak loudly and repeated themselves often when communicating with residents in care.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20241101103650
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: 11/07/2024
NARRATIVE
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On 11/04/24 between 9:48 am- 12:30pm LPA conducted interview with R1 regarding the allegation above, R1 reports It is not the staff who screams racist things at R1 it is another resident in care. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interviews with residents #2-6 (R2-R6) regarding the allegation above, 2 of 5 residents interviewed confirmed the allegation above and reported the administrator is rude and disrespectful to residents in care, 3 of 5 residents interviewed denied the allegation above. On 11/04/24 between 12:30pm-1:30 pm LPA conducted interviews with staff 1-3 (S1-S3) regarding the allegation above, 3 of 3 staff interviewed denied the allegation above.

Allegation: Staff are over medicating resident

It is being alleged that the facility psychiatrist comes into R1’s room at night with 2 LVN's and administers R1 prescribed medication and injection to make R1 sleep. On 11/07/24 LPA conducted interview with A1 regarding the allegation above, A1 denied the allegation above and reported all medications are administrator as prescribed. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interview with R1 regarding the allegation above, per R1 facility psychiatrist with LVN’s are going into R1’s room at night to try to give R1 5 needles of 100 milligrams each. On 11/04/24 between 9:48 am- 12:30pm LPA conducted interviews with residents #2-6 (R2-R6) regarding the allegation above, 5 of 5 residents interviewed denied the allegation above. On 11/04/24 between 12:30pm-1:30 pm LPA conducted interviews with staff 1-3 (S1-S3) regarding the allegation above, 3 of 3 staff interviewed denied the allegation above, 1 of 3 staff interviewed reported having no knowledge on medication administration procedures. On 11/04/24 LPA Villegas conducted review of MAR for October 2024 and there is no indication that R1 receives any injectable medications. On 11/05/24 LPA conducted interview with witness #1 (W1) regarding the allegation above, W1 denied the allegation and reported R1 does not have any injectable medications prescribed.

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 Administrator Ella Naygas, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3