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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603172
Report Date: 09/12/2024
Date Signed: 09/12/2024 12:32:19 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/04/2024 and conducted by Evaluator Christian Gutierrez
COMPLAINT CONTROL NUMBER: 28-AS-20240904114722
FACILITY NAME:SAVANT OF NORWALKFACILITY NUMBER:
198603172
ADMINISTRATOR:CHANEL A. SANCHEZFACILITY TYPE:
740
ADDRESS:11515 FIRESTONE BLVDTELEPHONE:
(562) 379-9200
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:80CENSUS: 79DATE:
09/12/2024
UNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Administrator Rachelle ReyesTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility illegally evicted a resident in care.
Facility is not following resident's contract.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPAs) Christian Gutierrez, Myra Cota, and Luis Deleon conducted an unannounced complaint investigation regarding the above allegations. LPA was met by Administrator Rachella Reyes and explained the purpose of the visit.
The investigation consisted of the following: LPA Gutierrez requested and obtained copies of staff roster (LIC 500), client roster (LIC 9020), staff #1-3 interviews (S1-S3), resident #1-2 interview (R1-R2), identification and emergency information, physicians report dated 02/28/2024, admission agreement, house rules, police report numbers, warning letter, and MAR log.
The investigation revealed the following. Regarding Allegation(s): Facility illegally evicted a resident in care: It is alleged R1 was illegally evicted from the facility. LPA interviewed S1-S3 who were able to corroborate all accusations. R1-R2 where interviewed and it was determined R1 did not adhere to house rules per his admission agreement. 30-day eviction was reviewed and contained all elements needed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, there for the allegation is UNSUBSTANTIATED. See LIC 9099C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 2
Control Number 28-AS-20240904114722
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SAVANT OF NORWALK
FACILITY NUMBER: 198603172
VISIT DATE: 09/12/2024
NARRATIVE
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Facility is not following residents’ contract-It is alleged facility was not following resident’s contract LPA obtained R1s admission agreement along with house rules. LPAs interviews with S1-S3 corroborate R1 was not following house rules. Interview with R1 reveled that R1 was aware of house rules and admission agreement and given copy signed on 02/29/2024. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, there for the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC9099 (FAS) - (06/04)
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