Terrace Post Acute

Los Angeles · CA · For profit - Corporation · WINDSOR chain · 133 certified beds · CCN 555738 · WINDSOR TERRACE HEALTHCARE LLC


Terrace Post Acute operates 133 certified beds in VAN NUYS, California. Its Medicare and Medicaid certification dates to 1999-07-08. It averages 120.2 residents a day.

What harm was found in the violations cited at Terrace Post Acute?

CMS lists 88 health-inspection deficiencies for Terrace Post Acute, all of them in the three years to 2026-08-01: the highest scope-and-severity letter on record is G; the most recent health inspection was 2026-06-04.

Survey dateTagDeficiencySeverity
2026-06-04F0825Provide or get specialized rehabilitative services as required for a resident.D
2026-04-21F0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.E
2026-04-21F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2026-04-08F0583Keep residents' personal and medical records private and confidential.D
2026-03-06F0880Provide and implement an infection prevention and control program.D
2026-01-15F0697, F0755, F0759, F0761, F0803, F0842Provide safe, appropriate pain management for a resident who requires such services. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. / Ensure medication error rates are not 5 percent or greater. / Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. / Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. / Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.E
2026-01-15F0580, F0657, F0684, F0692, F0695, F0730, F0809, F0814, F0880Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. / Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide enough food/fluids to maintain a resident's health. / Provide safe and appropriate respiratory care for a resident when needed. / Observe each nurse aide's job performance and give regular training. / Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. / Dispose of garbage and refuse properly. / Provide and implement an infection prevention and control program.D
2025-08-26F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.E
2025-08-19F0711Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.D
2025-05-19F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2025-05-06F0697, F0755Provide safe, appropriate pain management for a resident who requires such services. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2025-03-07F0676Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.D
2025-02-08F0880Provide and implement an infection prevention and control program.D
2025-01-30F0694, F0772Provide for the safe, appropriate administration of IV fluids for a resident when needed. / Have an agreement with an approved laboratory to obtain services, if on-site laboratory services aren't provided.D
2024-12-17F0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D
2024-12-06F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2024-11-21F0656, F0758, F0760, F0812, F0880Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. / Ensure that residents are free from significant medication errors. / Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. / Provide and implement an infection prevention and control program.E
2024-11-21F0578, F0600, F0657, F0658, F0684, F0689, F0695Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. / Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. / Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Ensure services provided by the nursing facility meet professional standards of quality. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Provide safe and appropriate respiratory care for a resident when needed.D
2024-11-14F0880Provide and implement an infection prevention and control program.D
2024-10-25F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2024-10-04F0773Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.D
2024-09-18F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.E
2024-09-18F0558, F0686Reasonably accommodate the needs and preferences of each resident. / Provide appropriate pressure ulcer care and prevent new ulcers from developing.D
2024-09-11F0697Provide safe, appropriate pain management for a resident who requires such services.D
2024-09-05F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.D
2024-07-25F0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.E
2024-07-05F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.E
2024-05-28F0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.D
2024-05-17F0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D
2024-05-07F0919Make sure that a working call system is available in each resident's bathroom and bathing area.E
2024-05-07F0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.D
2023-12-01F0692Provide enough food/fluids to maintain a resident's health.G
2023-12-01F0578, F0755, F0757, F0760, F0761, F0770, F0812, F0880Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. / Ensure each resident’s drug regimen must be free from unnecessary drugs. / Ensure that residents are free from significant medication errors. / Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. / Provide timely, quality laboratory services/tests to meet the needs of residents. / Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. / Provide and implement an infection prevention and control program.E
2023-12-01F0550, F0580, F0656, F0676, F0677, F0687, F0689, F0694, F0695, F0806, F0813, F0881Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. / Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. / Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. / Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide appropriate foot care. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Provide for the safe, appropriate administration of IV fluids for a resident when needed. / Provide safe and appropriate respiratory care for a resident when needed. / Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. / Have a policy regarding use and storage of foods brought to residents by family and other visitors. / Implement a program that monitors antibiotic use.D
2023-12-01F0638Assure that each resident’s assessment is updated at least once every 3 months.B
2023-11-22F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D
2023-10-18F0600, F0695Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. / Provide safe and appropriate respiratory care for a resident when needed.G
2023-10-18F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E
2023-10-18F0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.D
2023-08-31F0755, F0880Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. / Provide and implement an infection prevention and control program.D
2023-08-17F0573, F0760Let each resident or the resident's legal representative access or purchase copies of all the resident's records. / Ensure that residents are free from significant medication errors.D

Why was Terrace Post Acute fined?

DateTypeAmount
2023-10-18Fine$94,094

Has Terrace Post Acute had payment denied by Medicare?

Payment denial startLength in days
2023-12-3044

How is Terrace Post Acute staffed relative to the CA average?

MeasureThis facilityCA average
Total nurse staffing hours per resident per day3.865274.51570
Total nursing staff turnover (%)25.736.7
Average number of residents per day120.287.9

Who owns Terrace Post Acute, and what chain is it in?

Terrace Post Acute is registered with CMS as For profit - Corporation, operates under the legal business name WINDSOR TERRACE HEALTHCARE LLC and belongs to the WINDSOR chain.

RoleOwnerAssociation date
5% OR GREATER DIRECT OWNERSHIP INTERESTANTELOPE HOLDINGS I, LLC, ANTELOPE REALTY HOLDINGS I, LLCsince 06/30/2023
5% OR GREATER INDIRECT OWNERSHIP INTERESTROBIN, AARON, TRESS, AVROHOMsince 06/30/2022
CORPORATE OFFICERROBIN, AARON, TRESS, AVROHOMsince 08/14/2023
OPERATIONAL/MANAGERIAL CONTROLNEWGEN ADMINISTRATIVE SERVICES, LLC, BHARDWAJ, ASHWANI, SCANTLEBURY, INGRID, SHAW, PAMELAsince 06/30/2023
ADP OF THE SNFNEWGEN ADMINISTRATIVE SERVICES, LLC, BHARDWAJ, ASHWANI, SCANTLEBURY, INGRID, SHAW, PAMELAsince 06/30/2023

Were you or a family member harmed at Terrace Post Acute?