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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 04/09/2025
Date Signed: 04/09/2025 03:33:21 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
04/03/2025 and conducted by Evaluator Jose Calderon
COMPLAINT CONTROL NUMBER: 11-AS-20250403105629
FACILITY NAME:SAVANT OF SANTA MONICAFACILITY NUMBER:
198320378
ADMINISTRATOR:NATHANIEL VENZONFACILITY TYPE:
740
ADDRESS:1447 17TH STREETTELEPHONE:
(310) 829-5904
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY:174CENSUS: 93DATE:
04/09/2025
UNANNOUNCEDTIME BEGAN:
09:49 AM
MET WITH:ADMINISTRATOR NATHANIEL VENZONTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff did not meet resident's incontinence care needs
INVESTIGATION FINDINGS:
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On 04/09/2025 Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced visit to Savant of Santa Monica Facility and was greeted by Administrator Nathaniel Venzon (S1). LPA Calderon spoke to S1 prior to entering the facility to conduct a risk assessment. LPA Calderon explained the purpose of this visit is to deliver the finding pertaining to the above-mentioned allegation.

The investigation consisted of the following: LPA Calderon interviewed Administrator S1, Staff S2-S5, resident R1-R9. LPA Calderon obtained the following records: Preplacement information (dated 01/10/2024), physician report (dated 01/11/2024), incident report (dated 04/01/2025), Service Plan (dated 09/06/2024), shower logs (dated 02/10/2025 to 04/07/2025) for R1.

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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 11-AS-20250403105629
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: 04/09/2025
NARRATIVE
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Regarding the Allegation: Facility staff did not meet residents’ incontinence care needs.

This complaint alleged that staff did not meet incontinence care plan for R1. LPA Calderon toured the facility to include R1 room. LPA noted diapers, cleaning supplies, shower seat, creams to take care of R1 private parts. Records review indicate the following: R1 ISP, Physician report indicate health issues Incident reports indicate that R1 was taken to the hospital and evaluated with a UTI. Shower logs indicate that R1 was given a bed bath 11 times between 02/10/2025 to 04/07/2025. St. John Hospital record for medication for diagnosis Acute Cystitis without hematuria. Interviews indicate the following: 5 out of 5 staff deny not providing incontinence care for R1 or any other resident in care. R1 indicates that staff did not change R1 diaper until 12 noon. R1 indicates that staff did provide a shower to R1 every day of the week. R2 indicates that staff did not change R1 diaper until lunch and did not provide a shower weekly. 7 out of 9 residents indicate no need for incontinence care currently. 7 out of 9 residents indicate that they have seen staff provide incontinence care to other residents.

Based on interviews and supporting documentation, the preponderance of evidence standard has NOT been met therefore, the allegation of “facility staff did not meet residents’ incontinence care needs” found to be UNSUBSTANTIATED.


No deficiencies cited during today's visit.

An exit interview was conducted, and a copy of the Complaint Report were provided to the Administrator Nathaniel Venzon (S1).

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
LIC9099 (FAS) - (06/04)
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