198320378-4-2-2025-11-AS-RORN-DFZVFV-20250423162434

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 04/02/2025
Date Signed: 04/02/2025 04:53:23 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
03/24/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20250324095901

FACILITY NAME:	SAVANT OF SANTA MONICA		FACILITY NUMBER:	198320378
ADMINISTRATOR:	NATHANIEL VENZON		FACILITY TYPE:	740
ADDRESS:	1447 17TH STREET		TELEPHONE:	(310) 829-5904
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90404
CAPACITY:	174	CENSUS: 93	DATE:	04/02/2025
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Administrator, Nathaniel Venzon		TIME COMPLETED:	04:55 PM

ALLEGATION(S):

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Facility staff do not ensure residents personal belongings are safely secured

INVESTIGATION FINDINGS:

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On 4/2/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Administrator, Nathaniel Venzon and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:
On 4/2/25 LPA requested and reviewed copies of the following records: Staff roster, Resident Roster, Identification and Emergency Information, 4/30/24, Physician’s Report, 4/29/24, Resident Service Plan, 3/8/25, cute Care Transfer Log/list of Hospitalizations, March 2025, Laundry Schedule, Resident Personal Property list,4/30/24, Resident Theft and Loss Record, 3/24/25, Unusual Incident/Injury Report,3/24/25. LPA Felisa Shirley spoke to facility Administrator, Nathaniel Venzon, did a facility tour and interviewed Staff 1 through Staff 9 and Resident 1 through Resident 7.

Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025

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 3

Control Number 11-AS-20250324095901

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: 04/02/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Facility staff do not ensure residents personal belongings are safely secured

The details of the complaint allege that resident stated that upon her return to the facility she noticed that her personal belongings had been taken. LPA Felisa Shirley toured the facility and went to R1’s room, searched lost and found, and searched the facility’s laundry room lost and found.

LPA Shirley spoke to R1 and wrote down alleged missing items. LPA Shirley searched R1’s closet and dresser and found an article of clothing that R1 mentioned during phone call. During the tour of the facility, LPA Shirley observed the lost and found box located underneath the receptionist desk and did not locate R1’s missing items. LPA Shirley reviewed laundry schedule and went to the laundry room and searched through the lost and found clothing and did not observe other missing items of clothing mentioned by R1. During file review, LPA observed R1’s Resident Personal Property log dated, 4/30/24 and the log did not have alleged missing items listed as property that R1 brought with her to the facility.

LPA Shirley spoke with and interviewed staff 1 thru staff 9 (S-1 thru S-9). LPA ask, does staff ensure that residents personal belongings are safely secured? Of those interviewed, 9 out of 9 answered yes. LPA Shirley interviewed residents 1 thru resident 7 (R1 thru R7). LPA ask, does staff ensure that residents personal belongings are safely secured? Of those interviewed, 6 out of 7 answered yes and 1 resident answered no.

Con'd on 9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250324095901

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: 04/02/2025

NARRATIVE

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Based on interviews, available evidence, information received, and records reviewed there was not enough 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.

No deficiency was cited for this allegation.

An exit interview was conducted and a copy of this report was provided to the Business Office Manager, Shiree McCutchen

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025

LIC9099 (FAS) - (06/04)

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