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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603597
Report Date: 09/23/2025
Date Signed: 09/23/2025 01:09:15 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
09/18/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250918052014
FACILITY NAME:SAVANT OF ALHAMBRAFACILITY NUMBER:
198603597
ADMINISTRATOR:MADELEINE SIEVERTFACILITY TYPE:
740
ADDRESS:1 E COMMONWEALTH AVETELEPHONE:
(626) 289-3871
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:176CENSUS: 140DATE:
09/23/2025
UNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Madeleine Sievert, Administrator and Jessica Perez, Supervisor. TIME COMPLETED:
01:11 PM
ALLEGATION(S):
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Staff did not ensure resident's bandages were changed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced complaint visit to investigate the above-mentioned allegation. LPA met with Administrator Madeline Sievert and explained the reason for the visit.

The investigation consisted of LPA Interviewing five (5) staff S#1 – S#5, 10 (ten) residents R#1 – R#10, one (1) witness W#reviewing and obtaining staff and resident rosters, R1 Physicians Report for Residential Care Facilities for the Elderly (RCFE), Communication log dated 09/19/2025 with instructions for catheter, outside agency documentation from Home Health documenting service provided for R1, Physician’s order for R1 asking for increase in skill nursing visits for R1 to change and clean around catheter port dated 09/19/2025. Readmission of Care for Home Health dated 09/10/2025.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025
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 2
Control Number 28-AS-20250918052014
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SAVANT OF ALHAMBRA
FACILITY NUMBER: 198603597
VISIT DATE: 09/23/2025
NARRATIVE
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(continued from 9099)
The investigation revealed. Allegation: Staff did not ensure resident's bandages were changed. It is alleged that the facility is sending R1 with the same uncleaned bandages from two (2) days ago when R1 was last at dialysis center.

LPA interviewed five (5) staff, and all five (5) staff denied the allegation. Several staff stated that they do not change any bandages for R1 because that is done by Home Health Agency.

LPA interviewed ten (10) residents and ten (10) of ten (10) residents could not corroborate the allegation.

R1 has been going to dialysis 3 times a week and has had home health visit three times per week, the day after dialysis to inspect the portal site. The facility just got the physician's order for additional home health services on 09/19/2025. The facility stated they are prohibited from changing bandages and that it is the responsibility of Home Health to change/remove/inspect site and facility will be checking R1 after Home Health services R1, to make sure that Home Health is properly servicing R1. R1 stated R1 does not like to have the bandage on and will remove it. W1 stated they prefer that resident come in without bandage as it is for temporary use only. W1 stated that R1 did not come in with soaked bandage.

There is not enough supportive evidence to support this allegation.

Based on interviews, record review and observation, the information obtained during the investigation is insufficient to support the allegation. 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, therefore the allegation is UNSUBSTANTIATED.

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

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2