<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603597
Report Date: 01/03/2025
Date Signed: 01/03/2025 02:19:17 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
12/27/2024 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241227161938
FACILITY NAME:SAVANT OF ALHAMBRAFACILITY NUMBER:
198603597
ADMINISTRATOR:PHAM, LISAFACILITY TYPE:
740
ADDRESS:1 E COMMONWEALTH AVETELEPHONE:
(626) 289-3871
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY:176CENSUS: 118DATE:
01/03/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Madeleine Sievert, interim AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff mismanaged resident medication.
Facility staff left resident in soiled diaper for an extended amount of time.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation on the allegations listed above. LPA arrived unannounced and met with Maddie Sievert, the interim Executive Director. The reason for the visit was explained.

The investigation consisted of the following:
LPA obtained copies of the resident and staff rosters. LPA also reviewed Resident #1’s file and interviewed Staff and Residents. Resident #1 is no longer residing at the facility and was not interviewed.

The investigation revealed the following:
Allegation – Staff mismanaged resident medication. It is alleged that Resident #1’s medication was last given on 12/24/24. On 12/25/24, staff could not find the medications that had been delivered the day before.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
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-20241227161938
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: 01/03/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA interviewed the interim Administrator, 4 Staff and 10 Residents. According to interviews and record review, Resident #1 (R1) moved in on 12/17/24 and moved out on 12/23/24. Staff stated that R1 did not missed any medications. They stated R1 received all the medications from the Skilled Nursing Facility upon admission and did not have any medications delivered during the week of residing at the facility. LPA reviewed the medication log and staff initialed when the medications were given. There were none missed. LPA interviewed 10 residents regarding medications. 7 out of 10 residents stated they get their medications timely and have not missed any medications due to staff mismanagement. Based on information gathered, there is insufficient evidence to prove this allegation.

Allegation - Facility staff left resident in soiled diaper for an extended amount of time. It is alleged that resident was left in soiled diaper for over 30 minutes multiple times. LPA interviewed Staff and Residents for this allegation. Staff stated they do not keep any diaper changing logs. Staff denied leaving residents in soiled diaper for over 30 minutes. They stated they do wellness checks every 2 hours and will check the residents’ diapers during that time. They also change their diapers upon request. If a resident calls the front desk for assistance in changing the diaper, staff will immediately respond to the call and provide an estimated time to assist the resident. They stated they will change them as soon as possible. LPA interviewed 10 residents during the visit today. 2 out of 10 residents stated they have to wait a long time, between 2 - 3 hours, before staff will assist with a diaper change. The rest indicated the staff do not leave them in soiled diapers and will assist them timely or they change themselves.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.



An exit interview was conducted with M. Sievert. A copy of this report along with the appeal rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2