195850546-7-31-2025-29-AS-KLOZ-DK55F8-20250731195444

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850546
Report Date: 06/13/2025
Date Signed: 07/31/2025 10:33:12 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/28/2025 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20250428061537

FACILITY NAME:	SAVANT OF WOODLAND HILLS		FACILITY NUMBER:	195850546
ADMINISTRATOR:	SIDNEY, KEVAN		FACILITY TYPE:	740
ADDRESS:	21711 VENTURA BLVD		TELEPHONE:	(818) 999-2610
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	322	CENSUS: 106	DATE:	06/13/2025
		UNANNOUNCED	TIME BEGAN:	02:07 PM
MET WITH:	Sofiya, Wellness Director		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff did not document changes to resident's condition.
Staff did not obtain consent prior to moving resident into the memory care unit.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver investigation finding. Upon arrival LPA met with Sofiya Zaretsky, Wellness Director. The reason for the visit was explained.

On 04/28/2025, Community Care Licensing Division received the above allegations. On 05/07/2025, LPA conducted the initial complaint visit and conducted a physical plant tour which included random resident rooms, and common areas. From approximately (approx.)11am -1pm LPA interviewed six (6) residents and two (2) staff. Between 1pm-2:45pm LPA reviewed resident records and facility daily communication logs. In addition, on 05/02/2025 at approximately 3:45pm LPA conducted interview with potential witness.

Following is a summary of the allegations and investigation finding.
Regarding allegations “Staff did not document changes to resident's condition and Staff did not obtain consent prior to moving resident into the memory care unit”: (Continue to LIC9099c)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2025

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 29-AS-20250428061537

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF WOODLAND HILLS	FACILITY NUMBER: 195850546
	VISIT DATE: 06/13/2025

NARRATIVE

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It was reported that Resident #1 (R1) was moved to the memory care without documenting changes to the resident’s condition or notifying the residents responsible person. It was also mentioned that this transition was done without any prior notice or consent from the family.

Records reviewed confirmed R1 resided in the Assisted Living unit since 08/2020. Facility documentation showed that R1 began showing signs of cognitive decline, aggression and wandering behavior beginning in 01/2025 – 03/2025. Records reviewed revealed documentation of events leading up to R1’s move on 04/09/2025 to the memory care unit which is a secured unit with approved delayed egress exits. According to the ED and Health and Wellness Director it was unsafe for R1 to continue living in the AL due to R1’s increased confusion and exit seeking behavior. Staff interviews revealed that everything was communicated with R1, R1’s family and R1’s responsible person. Staff confirmed that R1 was able to speak english however was incoherent. Records reviewed and interviews conducted confirmed that R1’s family was aware of the move and R1’s responsible person signed the admission agreement (04/09/2025). Interview with R1’s responsible person revealed that they were aware of R1’s cognitive decline and the facility did communicate their observation of the change in R1’s condition. It was also confirmed that R1’s responsible person was aware of the necessary transfer and agreed to the transfer for R1’s safety.

Based on the above information gathered, there is insufficient evidence to support the allegations or that a violation occurred; therefore, the allegations “Staff did not document changes to resident's condition and Staff did not obtain consent prior to moving resident into the memory care unit” are deemed unsubstantiated at this time.

Exit interview conducted and copy of report provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2025

LIC9099 (FAS) - (06/04)

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