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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850546
Report Date: 03/11/2026
Date Signed: 03/11/2026 02:13:14 PM

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
03/04/2026 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20260304162151
FACILITY NAME:SAVANT OF WOODLAND HILLSFACILITY NUMBER:
195850546
ADMINISTRATOR:SIDNEY, KEVANFACILITY TYPE:
740
ADDRESS:21711 VENTURA BLVDTELEPHONE:
(818) 582-5455
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91364
CAPACITY:322CENSUS: 141DATE:
03/11/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kevan SidneyTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff does not ensure resident's prescribed medication is filled.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Martha Arroyo conducted an initial complaint visit to investigate the allegation noted above. Upon arrival, the LPA met with Executive Director (ED), Kevan Sidney and the reason for the visit was explained. Entrance interview.

During today’s visit, approximately between 09:10 a.m. and 11:10 a.m., the LPA conducted interviews with the ED, three staff members and seven residents, conducted a file review and a medication review of three randomly selected residents, and obtained copies of pertinent documents relevant to the investigation.

Report Continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026
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 2
Control Number 29-AS-20260304162151
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: 03/11/2026
NARRATIVE
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Report Continued from LIC 9099C...

It was alleged that staff does not ensure resident's prescribed medication is filled. It was reported that pain medication had been prescribed for the resident; however, the resident had not yet received the medication. A review of R1’s physician’s report dated 09/17/2025 lists the primary diagnoses as metabolic encephalopathy, emphysema, protein-calorie malnutrition, alcohol dependence, immunodeficiency, GERD, repeated falls, depression, neuropathy, and cannabis abuse. According to the report, R1 is able to care for their own personal needs, including bathing, dressing/grooming, feeding, managing toileting needs, managing personal cash resources, communicating their needs, following directions and instructions, and leaving the facility unsupervised. R1’s routine medication list includes Gabapentin 300 mg, one capsule by mouth three times daily; Aspirin EC 81 mg, one tablet by mouth once daily; and Lidocaine 4% patch, applied to the affected area for 12 hours once daily for pain. According to the medication review, R1’s routine medications are being administered as prescribed. Additionally, R1 has PRN medications that include Acetaminophen 325 mg, take two tablets by mouth every four hours as needed for pain, and Ibuprofen 800 mg, take one tablet by mouth every eight hours as needed for moderate to severe pain. However, according to the medication review, Ibuprofen has only been administered six (6) times since it was filled on 02/17/2026. An interview conducted with R1 revealed that they are currently taking Gabapentin for neuropathy pain. Although they experience pain and are aware that PRN pain medications are available, they prefer not to take them because they feel the medications take too long to take effect. Interviews conducted with staff revealed that R1 does have PRN pain medications prescribed; however, the resident does not request the medication to be administered when staff assist with routine medications. Staff also reported that all prescriptions are sent directly from the prescribing physician’s office to the pharmacy and then delivered to the facility. Furthermore, seven out of seven residents interviewed reported no concerns regarding their medications. Based on the information obtained and reviewed, the Department has insufficient evidence to say the alleged violation occurred. Therefore, allegation “staff does not ensure resident's prescribed medication is filled” is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2