198320378-3-4-2025-11-AS-RORN-DEXPQC-20250320113053

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 03/04/2025
Date Signed: 03/04/2025 05:38:46 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/02/2024 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20241002120926

FACILITY NAME:	SAVANT OF SANTA MONICA		FACILITY NUMBER:	198320378
ADMINISTRATOR:	NARINE MERTKHANYAN		FACILITY TYPE:	740
ADDRESS:	1447 17TH STREET		TELEPHONE:	(310) 829-5904
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90404
CAPACITY:	174	CENSUS: 90	DATE:	03/04/2025
		UNANNOUNCED	TIME BEGAN:	10:48 AM
MET WITH:	Executive Director, Nathaniel Venzon		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff do not respond to resident's call for assistance in a timely manner.
Staff are mismanaging resident medication.
Staff are not meeting resident's hygiene needs.
Staff are not keeping the facility clean or sanitary.

INVESTIGATION FINDINGS:

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On 03/04/2025 Licensing Program Analyst (LPA) Elvira Gonzalez conducted a subsequent unannounced complaint visit to further investigate the allegations listed above and deliver findings. LPA met with Maintenance Director, Francisco Orozco, and the purpose of this visit was explained. LPA was granted entry to the facility. Executive Director, Nathaniel Venzon, joined LPA shortly after.

The investigation consisted of the following: On 10/09/24, LPA Gonzalez obtained and reviewed the following documents: resident roster, staff roster, staff schedules for September 2024 and October 2024, facility maintenance schedule, and shower schedule. LPA Gonzalez conducted interviews with Narine Mertkhanyan, Administrator (A1), and staff #1 (S1), and conducted a tour of the facility. On 02/20/25, LPA Gonzalez received and reviewed the following documents: resident roster, staff roster, Admissions Agreement, Physician’s Report, Physician’s Order Report, Face Sheet, Personal Rights, and Medication Administration Records (MARs) for R2 dated: October 2024 – December 2024.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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 5

Control Number 11-AS-20241002120926

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SAVANT OF SANTA MONICA	FACILITY NUMBER: 198320378
	VISIT DATE: 03/04/2025

NARRATIVE

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Additionally, LPA Gonzalez inspected the Medication Room, and conducted interviews with staff #2-#5 (S2-S5), and residents #1-#6 (R1-R6). On 02/27/25, LPA Gonzalez conducted telephonic interviews with residents #7-9 (R7-R9). On 03/03/25 LPA received Medication Administration Records (MARs) dated: October 2024 – December 2024 for R10-R11.

The investigation revealed the following:

Allegation: Staff do not respond to resident's call for assistance in a timely manner. It is being alleged that residents are not attended to in a timely manner.

On 10/09/24 between 10:45 AM – 11:30 AM LPA Gonzalez conducted interviews with A1 and S1, and on 02/20/25 between 09:30 AM – 11:30 AM LPA Gonzalez conducted interviews with S2-S5. Based on interviews conducted, 5 out of 6 staff interviewed denied the allegation. 6 out of 6 staff interviewed confirmed residents have a callbox located in their rooms. They use the call button to alert staff, that call will go to a central monitoring station that is in the reception area. The receptionist will then answer the call, and radio a care staff to respond to the resident requesting assistance. 5 out of 6 staff interviewed stated that they are responding to residents’ call button alerts in a timely manner.

On 02/20/25 between 12:30 PM – 2:30 PM LPA Gonzalez conducted interviews with R1-R6 and on 02/27/25 between 02:05 PM – 02:45 PM LPA Gonzalez conducted interviews with R7-R9. Based on interviews conducted, 6 out of 9 residents interviewed stated that staff responds to their calls for assistance in a timely manner. 9 out of 9 residents interviewed stated that they are satisfied with the staff at this facility and the services provided to them.

Based on interviews conducted, the department did not find sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation, did or did not occur, therefore the allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20241002120926

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SAVANT OF SANTA MONICA	FACILITY NUMBER: 198320378
	VISIT DATE: 03/04/2025

NARRATIVE

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Allegation: Staff are mismanaging resident medication. It is being alleged that resident’s medications are routinely late. On 10/09/24 between 10:45 AM – 11:30 AM LPA Gonzalez conducted interviews with A1 and S1, and on 02/20/25 between 09:30 AM – 11:30 AM LPA Gonzalez conducted interviews with S2-S5. Based on interviews conducted, 4 out of 6 staff interviewed denied the allegation. 5 out of 6 staff interviewed stated that all resident’s medications are dispensed according to the physician’s orders.

On 02/20/25 between 12:30 PM – 2:30 PM LPA Gonzalez conducted interviews with R1-R6 and on 02/27/25 between 02:05 PM – 02:45 PM LPA Gonzalez conducted interviews with R7-R9. Based on interviews conducted, 7 out of 9 residents interviewed stated that staff administers their medication according to the physician’s orders. 7 out of 9 residents interviewed stated they have no issues with staff and their medications not being dispensed on time.

LPA Gonzalez conducted a record review of the MARs (dated: 10/01/24 – 12/31/24) and did not observe any discrepancies or mismanaging of resident’s medication.

Based on observation, interviews conducted, and records reviewed, the department did not find sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation, did or did not occur, therefore the allegation is unsubstantiated.

Allegation: Staff are not meeting resident's hygiene needs. It is being alleged that there have been issues with the residents getting help with bathing. It is also being alleged that a resident was left soiled and unattended. A record review of the shower schedule for residents who require assistance revealed that residents are scheduled with an assisted shower 1 to 3 times a week.

On 10/09/24 between 10:45 AM – 11:30 AM LPA Gonzalez conducted interviews with A1 and S1, and on 02/20/25 between 09:30 AM – 11:30 AM LPA Gonzalez conducted interviews with S2-S5. Based on interviews conducted, 6 out of 6 staff interviewed denied the allegation. 5 out of 6 staff interviewed stated that residents bathing service needs are being met. 6 out of 6 staff interviewed stated that residents are scheduled to shower 1-3 times a week, and as needed.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20241002120926

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SAVANT OF SANTA MONICA	FACILITY NUMBER: 198320378
	VISIT DATE: 03/04/2025

NARRATIVE

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On 02/20/25 between 12:30 PM – 2:30 PM LPA Gonzalez conducted interviews with R1-R6 and on 02/27/25 between 02:05 PM – 02:45 PM LPA Gonzalez conducted interviews with R7-R9. Based on interviews conducted 9-9 residents interviewed stated that they have not been left soiled and unattended by staff. 9 out of 9 residents interviewed stated that they are assisted with showering 1-3 times a week, and as needed. 9 out of 9 residents interviewed stated that they are satisfied with the staff at this facility and the services provided to them.

Based on observation, interviews conducted, and records reviewed, the department did not find sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation, did or did not occur, therefore the allegation is unsubstantiated.

Allegation: Staff are not keeping the facility clean or sanitary. It is being alleged that the carpet in a resident’s room is now black from spills.

On 10/09/24 between 10:45 AM – 11:30 AM LPA Gonzalez conducted interviews with A1 and S1, and on 02/20/25 between 09:30 AM – 11:30 AM LPA Gonzalez conducted interviews with S2-S5. Based on interviews conducted, 6 out of 6 staff denied the allegation. 5 out of 6 staff stated that the facility is kept clean and sanitary. An interview with S2 communicated that the carpets are cleaned monthly and as needed. S2 stated that they have been working on removing the carpet from resident’s rooms and replacing it with wood flooring, and that they are averaging to do two rooms a month, sometimes three.

On 02/20/25 between 12:30 PM – 2:30 PM LPA Gonzalez conducted interviews with R1-R6 and on 02/27/25 between 02:05 PM – 02:45 PM LPA Gonzalez conducted interviews with R7-R9. Based on interviews conducted 9 out of 9 residents interviewed denied the allegation. 9 out of 9 residents interviewed that the facility is kept clean and sanitary.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20241002120926

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SAVANT OF SANTA MONICA	FACILITY NUMBER: 198320378
	VISIT DATE: 03/04/2025

NARRATIVE

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On 10/09/24, LPA Gonzalez conducted a tour of the facility. LPA observed the facility to be clean and, sanitary and in good repair. LPA did not notice any black stains in the rooms that had carpet.

Based on observation, interviews conducted, and records reviewed, the department did not find sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation, did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with Executive Director, Nathaniel Venzon, and a copy of this report and appeal rights was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC9099 (FAS) - (06/04)

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