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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 12/03/2024
Date Signed: 12/03/2024 02:55:57 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/06/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20241106121450
FACILITY NAME:SAVANT OF BURBANK EASTFACILITY NUMBER:
198603136
ADMINISTRATOR:ACHARYA, NIRJARAFACILITY TYPE:
740
ADDRESS:1900 GRISMER AVETELEPHONE:
(818) 843-3141
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY:100CENSUS: 93DATE:
12/03/2024
UNANNOUNCEDTIME BEGAN:
11:12 AM
MET WITH:Imelda VillanuevaTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Staff handle resident in a rough manner
Staff are not addressing the residents dental needs
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Gary Tan and Michael Cava conducted a complaint visit to the facility to conclude the allegation regarding the above allegations. The ten day visit was made by LPAs Tan and Cava on November 6, 2024. Today’s investigation consisted of interviews, record review and a physical plant inspection.

Staff handle resident in a rough manner:
In regards to the allegation, it was reported that when Resident 1 (R1) went to the hospital, R1 was observed with bruises on the leg and arm. It was further reported that R1 commented that staff was rough when they were getting assistance with bathing. Staff was not identified by R1 or the reporting party. Moreover, no witnesses were identified. Interviews with the administrator and staff deny the allegation. No concerns or reports were ever made by R1. Interviews with administrator and staff, and record review also reveal that R1 is prescribed a blood thinner medication, and had dialysis at least three times per week.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
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 31-AS-20241106121450
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SAVANT OF BURBANK EAST
FACILITY NUMBER: 198603136
VISIT DATE: 12/03/2024
NARRATIVE
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Interviews with ten (10) of ten residents do not corroborate with the allegation. Based on the information obtained, there was insufficient evidence to prove staff handled R1 in a rough manner. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not addressing the residents dental needs:
In regards to the allegation, it was reported that R1’s dental hygiene appears to have been neglected because R1 had a severe dental decay. Interviews with administrator and staff deny the allegation, stating incidental medical and dental needs, including making appointments are met. Both administrator and staff adds that R1 was also capable of making their own appointments for their medical, dental and dialysis appointments. R1 never expressed to them any concerns that staff are not meeting their assistance with dental needs. During their stay at the facility, R1 had never complained of oral or tooth pain. Moreover, staff stated that R1 is able to take care of their hygiene needs. R1 no longer lives at the facility. They moved out 11/03/23. Review of R1’s records reveal that R1 has the capacity to dress and groom self, and is not at risk if allowed direct access to personal grooming and hygiene items. Interviews with ten (10) of ten residents do not corroborate with the allegation of staff not being able to assist with their medical or dental needs. Based on the information obtained, there was insufficient evidence to prove staff did not address R1’s needs. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC9099 (FAS) - (06/04)
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