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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 03/04/2025
Date Signed: 03/04/2025 02:40:32 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
02/25/2025 and conducted by Evaluator Alfonso Iniguez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250225112313
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: 61DATE:
03/04/2025
UNANNOUNCEDTIME BEGAN:
08:26 AM
MET WITH:Bella Naygas/AdministratorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff did not ensure the safety of food provided to residents.
Staff did not ensure a safe environment was provided for residents.
INVESTIGATION FINDINGS:
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On 3/4/2025 LPA Alfonso Iniguez conducted an unannounced subsequent complaint visit. LPA Iniguez met with Bella Naygas / Administrator. LPA Iniguez explained the purpose of this visit.

Investigation Consisted of: LPA conducted the following interviews: Administrator Interview(A#1), Staff Interviews (S#1-S#5) and Resident’s interviews (R#1-R#6). LPA obtained and reviewed the following documents: Resident Roster (dated 3/1/2025), staff roster (dated 3/1/25), Facility’s Dietitian Notes (dated: 11,29,2024-12,27,24 and 1,5,25), (R#1)’s Physicians Assessment (dated:6/12/24), Facility’s cook California Food Handler Certificate (dated: 6/25/2024) and a Physical tour of the kitchen.


Evaluation Report continues LIC 9099-C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
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 4
Control Number 11-AS-20250225112313
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: 03/04/2025
NARRATIVE
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Investigation Revealed the Following:

Allegation: Staff did not ensure the safety of food provided to residents.

The details of the complaint alleged that (R#1) and other residents in care are getting food poisoning from facility’s food.



On March 4, 2025, at approximately 9:00 AM, during records review, LPA Iniguez observed (R#1)’s medical history binder; there are no hospital medical records regarding (R#1) going to the hospital due to food poisoning. In addition, LPA Iniguez reviewed the facility’s dietitian notes (dated November, December 2024, and January 2025); the facility dietitian comes every month to conduct a kitchen evaluation where she checks the kitchen’s cooler, freezer, food storage areas, beverage areas, and overall areas. Furthermore, LPA reviewed the facility’s Cook California Food Handler Certificate (dated 6/25/2024); the certificate expires on 6/25/2027. Moreover, at approximately 12:30 PM, LPA Iniguez conducted a physical tour of the kitchen; LPA observed the kitchen areas were clean and well organized; also, LPA observed that the cook and kitchen staff followed safety food preparation guidelines when preparing meals for the residents in care and staff.

On March 4, 2025, at approximately 9:30 AM, during an Interview with the Administrator (A#1), she stated that the facility offers three meals per day plus snacks to all residents in care and sometimes facility staff. Also, (A#1) stated that the food served at the facility is safe to consume, and the facility has a dietitian who comes every month to ensure the kitchen areas, and the food are up to code. In addition, (A#1) stated that there are no incidents regarding (R#1) or other residents getting food poisoned by the food they eat here.

Evaluation Report continues LIC 9099-C...
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20250225112313
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: 03/04/2025
NARRATIVE
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On March 4, 2025, at approximately 10:00 AM, during interviews with residents (R#1-R#6), (5) out of (6) stated that the facility offers them three meals per day plus snacks between meals, also they stated that they have never got food poison or sick by the food the facility provided to them.

On March 4, 2025, at approximately 11:00 AM, during interviews with facility staff (S#1-S#5), (5) out of (5) stated that the facility provides three meals per day to all residents in care and sometimes facility staff. Also, they stated that the food the facility serves to the residents in care is safe to consume, and there have been no incidents regarding (R#1) or other residents getting food poisoned by the food they eat here.

Allegation: Staff did not ensure a safe environment was provided for residents.

The details of the complaint alleged that (R#1) is getting stalked by unknow cloaked figure.



On March 4, 2025, at approximately 9:30 AM, during an Interview with the Administrator (A#1), she stated that they had never received a complaint from (R#1) or another resident regarding an unknown cloaked individual stalking residents in the facility. In addition, (A#1) stated that the facility ensures the safety of the residents by conducting daily room checks, a sign-in system at the entrance of the facility, and a facility staff that monitors who comes in and out.

On March 4, 2025, at approximately 10:00 AM, during interviews with residents (R#1-R#6), (5) out of (6) stated that they have never seen an unknown cloaked individual stalking them, also, they stated that they feel safe living here.

Evaluation Report continues LIC 9099-C...
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20250225112313
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: 03/04/2025
NARRATIVE
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On March 4, 2025, at approximately 11:00 AM, during interviews with facility staff (S#1-S#5), (5) out of (5) stated that they had never received a complaint from (R#1) or another resident regarding an unknown cloaked individual stalking residents in the facility. In addition, (5) out of (5) facility staff stated that the facility ensures the safety of the residents by conducting daily room checks, a sign-in system at the facility's entrance, and a facility staff that monitors who comes in and out.



During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegation(s).

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.


An exit interview was conducted, and a copy of the Complaint Report was given to Bella Naygas / Administrator.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4