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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320456
Report Date: 09/14/2026
Date Signed: 09/14/2026 03:31:18 PM

Substantiated


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
09/10/2026 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260910144519
FACILITY NAME:TERRAZA COURT SENIOR LIVINGFACILITY NUMBER:
198320456
ADMINISTRATOR:LINDA POYTHRESSFACILITY TYPE:
740
ADDRESS:10955 WASHINGTON BLVDTELEPHONE:
(310) 838-7800
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:170CENSUS: 98DATE:
09/14/2026
UNANNOUNCEDTIME BEGAN:
09:57 AM
MET WITH:Linda Poythress -AdministratorTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff do not provide responsible party with copies of resident’s records.
INVESTIGATION FINDINGS:
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On 09/14/26, the department conducted an unannounced complaint investigation at the facility listed above. The department met with Linda Poythress, Administrator, and the purpose of the visit was explained. The department was granted access to the facility.

The investigation consisted of the following: On 9/14/26, the department requested the following documentation: staff roster, resident roster, and copies of emails between staff #1 (S1) and resident #1 (R1) family (F1). The depart conducted a review of R1’s service records and obtained copies of the following documents: Identification and Emergency Information, Residence and Care Agreement, Appendix G of the Residence and Care Agreement, POA documents, and Personal Rights. Additionally, the department conducted interviews with staff #1-#2 (S1-S2), and attempted to interview staff #3 (S3), but was unable to as they were not in the facility.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
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-20260910144519
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: 09/14/2026
NARRATIVE
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The complaint revealed the following:

For the allegation: "Staff do not provide responsible party with copies of resident’s records." On 09/14/26, the department conducted an interview with S1-S2, and attempted to interview S3, but was unable to as they were not in the facility. Based on interview conducted, 2 out of 2 staff denied the allegation. An interview with S1 revealed that F1 contacted S1 via email on 08/28/26 requesting copies of R1’s service records. S1 stated that they were out sick and unable to respond to F1 until they returning to work on 09/08/26. According to S1, the requested documents were subsequently sent out to F1 via email on 09/11/26.

On 09/14/26, the department reviewed emails exchanged between F1 and S1 regarding the requested service documents for R1. The review documented that, on 08/28/26, F1 emailed S1 requesting copies R1’s service records. A follow up email from F1 to S1, dated 09/02/26, documented that F1 was following up on a previous email on 08/28/26 regarding the requested records. An email from S1 to F1 dated 09/03/26 documented that S1 was out sick and would provide the requested documents as soon as possible. An email from S1 to F1 dated 09/11/26 documented that the requested documents had been emailed to F1.

Furthermore, the department reviewed Appendix G, of the Residence and Care Agreement, Statement of Resident’s Personal Rights, page G-5, section (19) where it states the following: To have prompt access to review all of their records and to purchase photocopies of their records. Photocopies records shall be provided within two (2) business days…

Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099-D and a copy of this report was provided with appeal rights.

An exit interview was conducted, and a copy of this report was provided to Linda Poythress.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260910144519
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/21/2026
Section Cited
CCR
87468.2(a)(19)
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87468.2 Additional Personal Rights of Residents...(a) In addition to the rights listed in Section 87468.1...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (19) To have prompt access to review all of their records and to purchase photocopies of their records. Photocopied records shall be provided within two (2) business days and at a cost that does not exceed the community standard for photocopies.

This requirement was not met:
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Administrator will review the cited section and shall self-certify understanding and compliance with the regulation. POC shall be submitted to CCLD via email at Elvira.Gonzalez@dss.ca.gov by the POC due date.
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Based on record review, and interviews conducted, staff did not provide copies of residents records to their responsible party within two (2) business days.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3