198603136-12-12-2024-31-AS-NMAN-DDS2CQ-20250210161703

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 12/12/2024
Date Signed: 12/12/2024 10:16:52 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
09/27/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20240927130858

FACILITY NAME:	SAVANT OF BURBANK EAST		FACILITY NUMBER:	198603136
ADMINISTRATOR:	ACHARYA, NIRJARA		FACILITY TYPE:	740
ADDRESS:	1900 GRISMER AVE		TELEPHONE:	(818) 843-3141
CITY:	BURBANK	STATE: CA	ZIP CODE:	91504
CAPACITY:	100	CENSUS: 92	DATE:	12/12/2024
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Imelda Villanueva		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is in disrepair
Staff do not keep the facility free from odor
Staff do not ensure that resident's toileting needs are met
Staff do not treat residents with dignity or respect
Staff do not provide residents with daily activities.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegations. LPA met with Imelda Villanueva and explained the reason for the visit.

---Facility is in disrepair

It was alleged that Resident #1's (R1) toilet was leaking for two (02) months before it was fixed. To investigate the allegation, LPA conducted a physical plant tour at around 10:00a.m., requested pertinent documents at around 11:00a.m., interviewed five (05) staff from 11:30a.m. to 1:00p.m. and nine (09) residents from 1:00p.m. to 3:30p.m. During the physical plant tour, LPA did not observe any leaking toilets.

(CONT on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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 4

Control Number 31-AS-20240927130858

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: 12/12/2024

NARRATIVE

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A review of the facility maintenance log indicates the leak was reported 09/26/24 at around 1:00p.m. and repaired 10/01/24 at around 12:45p.m. During interviews with staff, Staff #2 (S2) stated facility had to change the angle stop, cut back the pipe and insert a new valve further in to seal it. S2 added the whole process took about a week and arrangements were made for the two (02) occupants during repairs so as not to disrupt their care. All other staff stated they are unaware of any leaking toilets during the time in question. During interviews with residents, R1 stated toilet was leaking for two (02) months before it was fixed but now it is working properly. R1 also confirmed that arrangements were made for them to use a different toilet while staff performed repairs. All other residents stated they are unaware of any leaking toilets. Although toilet was leaking, facility took the necessary steps for expedited repairs and provided residents with an easily accessible alternative.

Based on observations, record review and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff do not keep the facility free from odor

It was alleged that facility consistently smells like urine and feces. To investigate the allegation, LPA conducted a physical plant tour at around 10:00a.m., interviewed five (05) staff from 11:30a.m. to 1:00p.m. and nine (09) residents from 1:00p.m. to 3:30p.m. During the physical plant tour, LPA did not experience consistent malodor. During interviews with staff, all staff stated it does not consistently smell like urine and feces. During interviews with residents, R1 stated the hallways are always smelling, and facility does not do a good job of keeping the place free from odor. All other residents stated they do not believe the facility consistently smells like urine and feces.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff do not ensure that resident's toileting needs are met

It was alleged that residents are left lying in their own waste. To investigate the allegation, LPA interviewed five (05) staff from 11:30a.m. to 1:00p.m. and nine (09) residents from 1:00p.m. to 3:30p.m.
(CONT. LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20240927130858

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: 12/12/2024

NARRATIVE

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During interviews with staff, all staff stated residents are not left soiled for an extended time and caregivers check and change residents every two (02) to three (03) hours or more if needed. During interviews with residents, R1 stated residents are left soiled for an extended time and caregivers are not attending to resident needs. All other residents stated staff do not leave residents lying soiled for an extended time.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff do not treat residents with dignity or respect

It was alleged that staff speak inappropriately to residents. To investigate the allegation,LPA interviewed five (05) staff from 11:30a.m. to 1:00p.m. and nine (09) residents from 1:00p.m. to 3:30p.m. During interviews with staff, all staff stated they treat all residents with dignity and respect. During interviews with residents, R1 stated staff are rude and speak inappropriately to other residents. R1 added that ever since Staff #3 (S3) joined, it has been much better. One (01) out of nine (09) residents stated staff “sometimes” speak to residents inappropriately. All other residents stated staff treat residents with respect and dignity.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff do not provide residents with daily activities

It was alleged that there are no activities for residents in the facility. To investigate the allegation, LPA conducted a physical plant tour at around 10:00a.m., requested pertinent documents at around 11:00a.m., interviewed five (05) staff from 11:30a.m. to 1:00p.m. and nine (09) residents from 1:00p.m. to 3:30p.m. During the physical plant tour, LPA observed activities calendar posted on the walls and copies of the activities being distributed. LPA also observed residents participating in activities. A review of the facility’s activities calendar shows multiple activities for residents to participate in daily. During interviews with staff, all staff stated they have an activities coordinator and there are plenty of activities for residents to participate in.

(CONT. on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20240927130858

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: 12/12/2024

NARRATIVE

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During interviews with residents, R1 stated they do have activities, but they are upstairs, and if they put it downstairs near the television area, a lot more people would participate. R1 added that the games they offer are not very entertaining. All other residents stated facility has activities for residents to participate in.

Based on observations, record review and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

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