198320378-9-29-2025-11-AS-SCIS-DMC33N-20251010175350

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 09/29/2025
Date Signed: 09/29/2025 03:15:23 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
09/24/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20250924105048

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: 130	DATE:	09/29/2025
		UNANNOUNCED	TIME BEGAN:	09:43 AM
MET WITH:	Shiree McCutchen, Business Office Manager		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff did not take proper steps to mitigate the spread of a communicable disease.

INVESTIGATION FINDINGS:

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On 9/29/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the 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 9/29/25 LPA Shirley reviewed copies of the following records: Staff and Client Roster, In- Service Training Signature Sheet, Cleaning and Disinfection Log, Client Face Sheet, Admission Record, Preplacement Appraisal Information, Medical Assessment for Residential Care Facilities for the Elderly, Immunization History Report, Service Plan, Special Incident Reports, Infection Control Plan. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff-8 (S1 – S8), and Resident -1 – Resident -10 (R1-R10)).

Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250924105048

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: 09/29/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff did not take proper steps to mitigate the spread of a communicable disease.

It was reported that there were deficiencies in staff’s covid-19 prevention efforts. On 9/29/25, LPA Felisa Shirley reviewed Savant of Santa Monica’s Infection Control plan and staff were found to be in compliance with established protocols. Upon further investigation LPA Shirley observed the annual In-Service Signature Sheet for Covid, Infection Control and PPD done and doffing. LPA Shirley also observed the Cleaning and Disinfection Log for sanitizing frequently touched surfaces signed by staff and the Maintenance Director. During the tour of this facility, LPA Shirley observed the PPE Supply Carts that were utilized by staff during the period of isolation for the purpose of preventing the spread of infectious disease.

LPA interviewed staff 1 – staff 8 (S-1 – S-8). Of those interviewed 8 out of 8 denied the allegation. LPA interviewed resident 1 – resident 10 (R1 – R10). Of those who interviewed 8 denied the allegation, 1 confirmed the allegation and 1 was not sure.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff did not take proper steps to mitigate the spread of a communicable disease,” therefore, 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: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

LIC9099 (FAS) - (06/04)

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