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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610366
Report Date: 03/05/2025
Date Signed: 03/05/2025 02:00:40 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
02/27/2025 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20250227114052
FACILITY NAME:SAVANT OF TARZANAFACILITY NUMBER:
197610366
ADMINISTRATOR:RITA MELDONIANFACILITY TYPE:
740
ADDRESS:5711 RESEDA BLVDTELEPHONE:
(818) 996-2022
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:176CENSUS: 91DATE:
03/05/2025
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Marilou MendozaTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are not distributing resident's medications as prescribed
INVESTIGATION FINDINGS:
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At approximately 11:15 a.m. on 03/05/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the administrator and disclosed the reason for the visit.

To investigate the allegation above, LPA toured the facility at 11:20 a.m. today, interviewed staff and residents between 11:30 a.m. and 1:15 p.m., and conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 12:30 p.m.

Regarding the allegation "Staff are not distributing resident's medications as prescribed" it was alleged Resident #1 (R1) was not receiving staff assistance with their medication. Interview with Staff #1 (S1) at 12:00 p.m. revealed R1 was recently admitted to the facility and has had some difficulty adjusting to the new setting. Record review of R1’s Medication Administration Record (MAR) showed R1 received staff assistance with all of their medications at every required time. No entries in the MAR were blank or missing.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
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-20250227114052
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: 03/05/2025
NARRATIVE
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R1’s MAR showed that they refused medication between 02/23/25 and 02/27/25. Interview with Staff #2 (S2) at 12:30 p.m. and Staff #3 (S3) at 12:40 p.m. confirmed that R1 verbally refused medications on the noted dates. S2 said R1 would yell at them and refuse medication. S3 said R1 would request staff come back at another time as they were not ready for medications. Both staff reported the refusals to their supervisors and R1’s physician. Interview with R1 at 1:00 p.m. today confirmed they are having trouble adjusting to the facility and have refused meals and medications. R1 confirmed staff have thoroughly assisted them with medications. Based on interviews and record review, staff properly distributed R1’s medications. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2