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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610366
Report Date: 03/08/2024
Date Signed: 03/08/2024 03:29:31 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/15/2024 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20240215141726
FACILITY NAME:SAVANT OF TARZANAFACILITY NUMBER:
197610366
ADMINISTRATOR:JINA MALEKSARKISSIANSFACILITY TYPE:
740
ADDRESS:5711 RESEDA BLVDTELEPHONE:
(818) 996-2022
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:176CENSUS: 59DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rita MeldonianTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff verbally abused resident while in care
INVESTIGATION FINDINGS:
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At 8:30 a.m. on 03/08/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and later the administrator and disclosed the reason for the visit. LPA was joined by Long Term Care Ombudsman (LTCO) Diane Torres at 9:00 a.m.

To investigate the allegation above, LPA conducted an initial visit on 02/20/2024 and toured the facility at 2:00 p.m., interviewed three (03) out of fifty-three (53) residents between 2:00 p.m. and 3:00 p.m., and interviewed four (04) staff between 3:00 p.m. and 3:30 p.m. Today, LPA interviewed seven (07) out of fifty-nine (59) residents, which was 10% of residents, and four (04) staff members between 8:45 a.m. and 1:00 p.m. and toured the facility at 11:00 a.m.

Regarding the allegation “Facility staff verbally abused resident while in care” it was alleged an unknown staff member verbally abused Resident #1 (R1). Interview with R1 at approximately 3:00 p.m. on 02/20/2024 revealed they never said the allegation and had no issues with verbal abuse from facility staff.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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 31-AS-20240215141726
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SAVANT OF TARZANA
FACILITY NUMBER: 197610366
VISIT DATE: 03/08/2024
NARRATIVE
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R1 stated they may have been verbally abused by hospital staff instead. R1 admitted that although they complain often, they were appreciative of the facility staff. Interviews with other residents and staff revealed no information about staff verbally abusing residents. Based on interviews, facility staff did not verbally abuse R1. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety hazards were observed during this visit.

Exit interview conducted. Copy of report provided.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2