197610366-7-12-2024-31-AS-NMAN-D9NUKP-20241002153929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610366
Report Date: 07/12/2024
Date Signed: 07/12/2024 04:44:29 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
05/28/2024 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20240528223247

FACILITY NAME:	SAVANT OF TARZANA		FACILITY NUMBER:	197610366
ADMINISTRATOR:	RITA MELDONIAN		FACILITY TYPE:	740
ADDRESS:	5711 RESEDA BLVD		TELEPHONE:	(818) 996-2022
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	176	CENSUS: 75	DATE:	07/12/2024
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Rita Meldonian		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff is threatening a resident with eviction

INVESTIGATION FINDINGS:

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At approximately 8:50 a.m. on 07/12/24, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced, subsequent complaint visit. LPA met with staff and later the Executive Director (ED) and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted an initial visit on 05/29/24 and interviewed the ED at 12:15 p.m., reviewed records pertinent to the investigation including but not limited to R1’s face sheet and emergency contacts form at 12:30 p.m., and toured the facility at 12:45 p.m. LPA called to interview a family member (F1) at 1:20 p.m. and the ED at 1:45 p.m. on 07/11/24. LPA called to interview R1 at 3:30 p.m. today.

Regarding the allegation “Staff is threatening a resident with eviction” it was alleged the facility threatened Resident #1 (R1) with eviction after their last two (02) checks bounced.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024

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 31-AS-20240528223247

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: 07/12/2024

NARRATIVE

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Interview with the ED at 12:15 p.m. on 05/29/24 confirmed R1’s check payments from April and May 2024 bounced and therefore the facility was not paid for those months. The facility issued an eviction for nonpayment on 05/27/24 but stated the eviction would be rescinded if R1 paid the outstanding balance. File review at 12:00 p.m. on 05/29/24 revealed the facility properly submitted the eviction notice to Community Care Licensing as well. Interview with F1 revealed the eviction was a “moot point” now as R1 was in the process of applying for the Assisted Living Waiver Program (ALWP) to pay their rent. Interview with the ED at 1:45 p.m. on 07/11/24 confirmed that R1 would return to the facility in approximately two (02) months when they became eligible to pay rent through the ALWP. Additionally, the facility now considers the eviction void. Interview with R1 at 3:30 pm today revealed no pertinent information. Based on interviews and file review, the facility properly issued R1’s eviction for nonpayment of rent. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety risks were observed during today’s visit.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024

LIC9099 (FAS) - (06/04)

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