198603319-3-12-2025-11-AS-SCIS-DGGVGT-20250508162604

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603319
Report Date: 03/12/2025
Date Signed: 03/12/2025 12:24:06 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
11/20/2024 and conducted by Evaluator Troy Watson

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20241120150825

FACILITY NAME:	BEVERLY HILLS TERRACE		FACILITY NUMBER:	198603319
ADMINISTRATOR:	STRIKS, AHARON		FACILITY TYPE:	740
ADDRESS:	1470 S ROBERTSON BLVD		TELEPHONE:	(310) 273-3668
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	110	CENSUS: 61	DATE:	03/12/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ella Naysberg - Administrator		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Staff speak inappropriately to resident.
Staff discourage resident from filing complaints.
Staff tamper and withhold resident’s mail for extended periods.
Staff discards residents’ mail.

INVESTIGATION FINDINGS:

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*This report was created to clarify findings.It does not supersed the report delivered on 02/10/25.

On 02/10/2025, Licensing Program Analyst (LPA) Troy Watson conducted an unannounced subsequent complaint investigation at the facility listed above. LPA Watson arrived at the facility and was greeted by the administrator Ella Naysberg. LPA Watson explained the purpose of the visit was to deliver findings and was granted entry.

The investigation consisted of the following: On 02/06/2025 LPA Troy Watson interviewed staff #1- staff #5 (S1-S5) and interviewed residents #1- residents #5 (R1-R5). LPA Watson requested, received, and reviewed the Personnel Report LIC 500, Resident Census / Active List, and signature signings of in - coming received mail documentation.

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20241120150825

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: 03/12/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff speak inappropriately to residents.

On 02/03/25 the department reviewed the facility files and found no incident reports relating to the allegation. On 02/06/2025 the department conducted interviews with staff#1 – staff #5 (S1-S5). The department asked the staff if they had spoken inappropriately with the residents. Of those interviewed, 5 out of 5 staff denied the allegation. On 02/06/2025 the department interviewed residents #1 – residents #5 (R1-R5). The department asked residents if staff had spoken inappropriately to them. Of those interviewed, 4 out 5 residents denied the allegation. Based on the information gathered, there is insufficient evidence to support the stated allegation.

Allegation: Staff discourage resident from filing complaints

On 02/03/25 the department reviewed the facility files and found no incident reports regarding the allegation above. On 02/06/2025 the department conducted interviews with staff#1 – staff #5 (S1-S5). The department asked the staff if they discouraged residents from filing complaints. Of those interviewed, 5 out of 5 staff denied the allegation. On 02/06/2025 the department conducted interviews with residents # 1 – residents #5 (R1-R5). The department asked residents if staff discouraged them from filing complaints. Of those interviewed 4 out 5 residents denied the allegation. Based on the information gathered, there is insufficient evidence to support the stated allegation.

Allegation: Staff tamper and withhold resident’s mail for extended periods.

On 02/03/25 the department reviewed the facility files and found no incident reports regarding the allegation above. On 02/06/2025 the department conducted interviews with staff#1 – staff #5 (S1-S5). The department asked the staff if they tamper and withhold resident’s mail for extended periods of time. Of those interviewed, 5 out of 5 staff denied the allegation. On 02/06/2025 the department conducted interviews with residents #1 – residents # 5 (R1-R5). The department asked residents if staff tampered and withheld residents’ mail. Of those interviewed 4 out 5 residents denied the allegation . Based on the information gathered, there is insufficient evidence to support the stated allegation.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20241120150825

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: 03/12/2025

NARRATIVE

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* This report serves as an amendment to clarify findings, it does not supersede the complaint investigation findings reflected on report created on 03/12/2025.

Allegation: Staff discards residents’ mail

On 02/03/25 the department reviewed the facility files and found no incident reports regarding the allegation above. On 02/06/2025 the department conducted interviews with staff#1 – staff #5 (S1-S5). The department asked the staff if they discard resident’s mail. Of those interviewed 5 out of 5 staff denied the allegation. On 02/06/2025 the department conducted interviews with residents #1 – residents #5 (R1-R5). The department asked residents if staff discarded their mail. Of those interviewed 4 out 5 residents denied the allegation. Based on the information gathered, there is insufficient evidence to support the stated allegation.

Based on the information collected from the facility inspection, observations, interviews, and records analysis, the Department found no evidence to support the above allegation. While the allegation may be valid or have occurred, there is insufficient evidence to establish whether the alleged violation took place or did not. Therefore, the allegation is deemed unsubstantiated.

An exit interview was conducted, and a copy of this report was provided to the Care Giver Alba Luz Lopez .

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC9099 (FAS) - (06/04)

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