198320378-4-2-2025-11-AS-RORN-DGMRLG-20250513130707

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 04/02/2025
Date Signed: 04/02/2025 04:55:54 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
02/19/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20250219081756

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: 98	DATE:	04/02/2025
		UNANNOUNCED	TIME BEGAN:	04:27 PM
MET WITH:	Business Office Manager, Shiree McCutchen		TIME COMPLETED:	04:55 PM

ALLEGATION(S):

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Staff did not attend to resident's in a timely manner
Staff sleep while on shift
Staff did not provide reasonable privacy to residents in care

INVESTIGATION FINDINGS:

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On 4/2/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced subsequent visit to this facility. LPA was met by Business Office Manager, Shiree McCutchen 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 2/21/25 LPA requested and reviewed copies of the following records: Staff roster, Resident roster, resident face sheet, Identification and Emergency Information, Physician’s Report, Admission Agreement, Release of Client/Resident Medical Information, Client/Resident personal property and valuables, copy of resident ID, and Your right to make decisions about medical treatment. 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 9.

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 4

Control Number 11-AS-20250219081756

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: Staff did not attend to residents in a timely manner

The details of the complaint allege that the residents calls are not answered by night shift staff and they are left in soaked briefs until morning staff arrives. On 2/21/25 between 9:03am – 10:30am, LPA Shirley interviewed R1 – R9. On 2/21/25 LPA Shirley toured the facility and pushed the call buttons in rooms 21A, 21B, 28, 34, 32B, and 50. LPA Shirley noted that the call box in room #28 was not working correctly. LPA Shirley pushed the call button on the call box three times and observed that the indicator on the call box did not light up. LPA Shirley turned the box over and observed that the wires were loose and therefore not giving an alert to the front desk. LPA Shirley assembled the wire around the screw behind the call box and then again pushed the button and the indicator lit up. As soon as the indicator lit up, the staff assigned to the front desk answered and said, “Front desk, how can I help you.”

LPA Shirley spoke with and interviewed staff 1 thru staff 9 (S1 thru S9). LPA ask, does staff attend to residents in a timely manner? Of those interviewed, 7 out of 9 staff answered yes, and 2 answered other than yes or no. LPA Shirley interviewed residents 1 thru resident 9 (R1 thru R9). LPA ask, does staff attend to your needs in a timely manner? Of those interviewed, 5 out of 9 residents answered no, 4 residents answered yes.

Regarding the allegation “Staff did not attend to residents in a timely manner, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

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)

Page: 2 of 4

Control Number 11-AS-20250219081756

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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Allegation: Staff sleep while on shift

LPA Shirley spoke with and interviewed staff 1 thru staff 9 (S1 thru S9). LPA ask, does staff sleep while on shift? Of those interviewed, 6 out of 9 staff answered no, 2 staff answered yes and one answered other than yes or no. LPA Shirley interviewed residents 1 thru resident 9 (R1 thru R9). LPA ask, do you believe the staff sleep during the nightshift? Of those interviewed, 3 out of 9 residents answered yes, 2 residents answered no and 4 answered other than yes or no.

Regarding the allegation “Staff sleep while on shift, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

Allegation: Staff did not provide reasonable privacy to residents in care

The details of the complaint allege that staff listens in on the rooms through the call boxes without the resident’s knowledge. On 2/21/25 between 9:03am – 10:30am, LPA Shirley interviewed Resident#1 – 9. During interviews, six residents stated that they can tell when the call box comes on because they can hear the static. LPA Shirley pushed six residents call buttons that were in their rooms during the time of the interviews. LPA Shirley verified that the call buttons were working and could hear when staff is about to speak and all received immediate responses once the buttons were pushed.

Con'd on 9099

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)

Page: 3 of 4

Control Number 11-AS-20250219081756

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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LPA Shirley spoke with and interviewed staff 1 thru staff 9 (S1 thru S9). LPA ask, does staff provide reasonable privacy to residents in care? Of those interviewed, 9 out of 9 staff answered yes. LPA Shirley interviewed residents 1 thru resident 9 (R1 thru R9). LPA ask, do you believe that you receive reasonable privacy? Of those interviewed, 7 out of 9 residents answered yes and 2 residents answered no.

Regarding the allegation “Staff did not provide reasonable privacy to residents in care, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

No deficiencies were cited for these allegations.

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)

Page: 4 of 4