198320378-10-21-2025-11-AS-SCIS-DNS3YE-20251125173949

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 10/21/2025
Date Signed: 10/21/2025 03:39:42 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
10/15/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20251015092819

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: 136	DATE:	10/21/2025
		UNANNOUNCED	TIME BEGAN:	10:21 AM
MET WITH:	Brook LaMotte, Wellness Director		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff pushed resident
Staff refused to give resident medication
Staff did not treat resident with respect

INVESTIGATION FINDINGS:

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On 10/21/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Wellness Director, Brooke LaMotte 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 10/21/25 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, De-Escalation In- Service Training Signature Sheet, Exodus Recovery Client Aftercare Plan, two (2) R-1 Warning Letters, Police Incident Report number, unusual Incident/Injury Reports, S-1 written notes, S-4 Written Statement, Client Face Sheet, Medication list, Preplacement Appraisal Information, Medical Assessment for Residential Care Facilities for the Elderly, and Service Plan. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff-6 (S1 – S6), 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: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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-20251015092819

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: 10/21/2025

NARRATIVE

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The investigation revealed the following:

Allegation Staff pushed resident

It is being reported that staff pushed a resident. On 10/21/25, LPA Felisa Shirley reviewed the incident reports for R-1 and observed that, S-3 and S-4 observed R-1 being upset and screaming at S-1 per incident report dated 10/5/25. Per review of Exodus Recovery, Client AfterCare Plan, R-1 was transferred by the police department to a recovery program following the incident involving the attack of a staff member. Per interviews conducted on 10/21/25, S-3 and S-4 observed R-1’s elbow approaching S-1’s neck/throat. Per S-4’s written statement, she observed R-1 kick the Med Room door shut.

LPA interviewed staff 1 – staff 6 (S-1 – S-6). Of those interviewed 4 out of 6 denied the allegation, 2 did not know. LPA interviewed resident 1 – resident 10 (R1 – R10). Of those who interviewed 9 denied the allegation, 1 confirmed the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff pushed resident,” therefore, the allegation is unsubstantiated.

Allegation Staff refused to give resident medication

It is being reported that staff refused to give R-1 their medication. Per interview with S-3 on 10/21/25, R-1 called the front desk requesting their medication and was told to come down to the Med Room. S-1 stated that he observed R-1 visibly shaking when the resident entered the Med Room from the wrong entrance for residents and S-1 sat R-1 down to assist and assess the resident to report to the doctor when suddenly R-1 began yelling and slammed the door shut.

LPA interviewed staff 1 – staff 6 (S-1 – S-6). Of those interviewed 6 out of 6 denied the allegation. LPA interviewed resident 1 – resident 10 (R1 – R10). Of those who interviewed 8 denied the allegation, 2 confirmed the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff refused to give resident medication,” therefore, the allegation is unsubstantiated.

Con'd on 9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20251015092819

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: 10/21/2025

NARRATIVE

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Allegation Staff did not treat resident with respect

It is being reported that staff did not treat a resident with respect. Per review of Unusual incident reports dated 10/14/25, R-1 was transferred to Los Angeles Downtown Medical Center, (LADMC) on an ordered 51/50 hold secondary to aggressive and violent behavior towards S-1 on 10/5/25 and is currently still in the medical center.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff did not treat resident with respect,” 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 Wellness Director, Brooke LaMotte.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC9099 (FAS) - (06/04)

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