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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603597
Report Date: 02/28/2025
Date Signed: 02/28/2025 04:21:50 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
01/30/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250130091414
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: 140DATE:
02/28/2025
UNANNOUNCEDTIME BEGAN:
02:21 PM
MET WITH:Madeline Sievert, Administrator TIME COMPLETED:
04:19 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are mismanaging residents medication
Staff are not responding to residents call buttons in a timely manner
Staff are not following infectious control requirements
Staff did not prevent residents from wandering from the facility
Staff did not provide resident's medical records to physician
Staff are not meeting residents dietary needs
Staff did not ensure elevators were not in disrepair
Staff are not fixing things in a timely manner
Staff are not meeting residents needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Alberto Lopez made subsequent visit at the facility for the purpose of continuing investigation and delivering findings for above-mentioned allegations. LPA Lopez met with Maddie Sievert, Interim Administrator and explained the purpose for the visit.

On 02/04/2025 - The investigation consisted of interviews with seven (7) staff (S#1-S#7), nine (9) residents (R#1-R#9). LPA reviewed and obtained, R5 MAR for month of January 2025, reviewed and obtained staff and resident rosters, reviewed medications for R5, and asked facility to send R5 LIC602 and admission agreement.

LPA interview total of eight (8) staff and ten (10) residents and reviewed and obtained medication destruction record for S5 medications that were missing. LPA inspected the elevators and room 147 bathrooms.

(continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
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 4
Control Number 28-AS-20250130091414
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: 02/28/2025
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
(continued from 9099)

The investigation revealed:

1) Staff are mismanaging residents medication. It is alleged that residents are not getting their medications or getting them on time.

LPA interviewed eight (8) staff and all eight (8) denied the allegation LPA interviewed ten (10) residents and six (6) of ten (10) residents were not able to corroborate the allegation. LPA reviewed medications for R5 and there were medications missing for dates that R5 was at Hospital. Staff sated they were popped out of the bubble in error and destroyed. Staff provided proof to LPA of medication destruction. There is not enough evidence to substantiate this allegation.

2) Staff are not responding to residents call buttons in a timely manner. It is alleged that residents are not getting their assistance on time.

LPA interviewed eight (8) staff and all eight (8) denied the allegation LPA interviewed ten (10) residents and eight (8) of ten (10) were not able to corroborate the allegation. There is not enough evidence to substantiate this allegation.

3) Staff are not following infectious control requirements. It is alleged that some residents are not being required to wear mask when there is a COVID outbreak.

LPA interviewed eight (8) staff and all eight (8) denied the allegation. Staff stated they encouraged the residents to wear a mask but cannot required them to wear them now. LPA interviewed ten (10) residents and seven (7) of ten (10) residents were not able to corroborate the allegation. The facility cannot require residents to wear a mask any longer. However, the facility continues to encourage wearing a mask during COVID outbreaks. There is not enough evidence to substantiate this allegation.

(continued on 9099C)

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20250130091414
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: 02/28/2025
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
(continued from 9099C)
4) Staff did not ensure elevators were not in disrepair. It is alleged that elevators are in disrepair.

LPA interviewed eight (8) staff and all eight (8) denied the allegation. Some staff stated that the residents tend to crowd the elevator and do not abide by the limit of 3 persons and that it causes the elevator to malfunction at times. Staff stated when the elevators do need repair, they are repaired promptly and never have the two elevators been broken down at the same time. LPA interviewed ten (10) residents and eight (8) of 10 residents were not able to corroborate the allegation. One resident stated that the elevator breaks down because too many people get in them at one time. Some residents stated that facility has them repaired right away. Facility has two elevators, and, on both visits, the elevators were working properly. There is insufficient evidence to support this allegation.

5) Staff are not fixing things in a timely manner. It is alleged that bathroom sink in room 147 is in disrepair and facility has not addressed it.

LPA took tour of room 147 and the bathroom sink was repaired and working properly during the two separate visits LPA made. LPA interviewed eight (8) staff and all eight (8) denied the allegation. LPA interviewed ten (10) residents and seven (7) of ten (10) residents were not able to corroborate the allegation. Most residents stated that facility repairs things right away. Residents stated they must put in a work order and facility responses in a reasonable time. There is insufficient evidence to support this allegation.

6) Staff are not meeting resident’s needs. It is alleged that staff do not respond to 24 hour phone when called during overnight hours.

LPA interviewed eight (8) staff and all eight (8) staff denied the allegation. One staff stated she has used the phone when trying to get access to facility in the early morning hours to begin her shift and the phone is answered promptly and has never been late due to no one answering the 24-hour phone. LPA interviewed ten (10) residents and six (6) of the ten (10) residents were not able to corroborate the allegation. Several residents stated that all their needs are being met. There is insufficient evidence to support this allegation.

(continue on 9099)

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20250130091414
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: 02/28/2025
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
(continued from 9099C)

7) Staff did not ensure elevators were not in disrepair. It is alleged that elevators are in disrepair.

LPA interviewed eight (8) staff and all eight (8) denied the allegation. Some staff stated that the residents tend to crowd the elevator and do not abide by the limit of 3 persons and that it causes the elevator to malfunction at times. Staff stated when the elevators do need repair, they are repaired promptly and never have the two elevators been broken down at the same time. LPA interviewed ten (10) residents and eight (8) of 10 residents were not able to corroborate the allegation. One resident stated that the elevator breaks down because too many people get in them at one time. Some residents stated that facility has them repaired right away. Facility has two elevators, and, on both visits, the elevators were working properly. There is insufficient evidence to support this allegation.

8) Staff are not fixing things in a timely manner. It is alleged that bathroom sink in room 147 is in disrepair and facility has not addressed it.

LPA took tour of room 147 and the bathroom sink was repaired and working properly during the two separate visits LPA made. LPA interviewed eight (8) staff and all eight (8) denied the allegation. LPA interviewed ten (10) residents and seven (7) of ten (10) residents were not able to corroborate the allegation. Most residents stated that facility repairs things right away. Residents stated they must put in a work order and facility responses in a reasonable time. There is insufficient evidence to support this allegation.

9) Staff are not meeting resident’s needs. It is alleged that staff do not respond to 24 hour phone when called during overnight hours.

LPA interviewed eight (8) staff and all eight (8) staff denied the allegation. One staff stated she has used the phone when trying to get access to facility in the early morning hours to begin her shift and the phone is answered promptly and has never been late due to no one answering the 24-hour phone. LPA interviewed ten (10) residents and six (6) of the ten (10) residents were not able to corroborate the allegation. Several residents stated that all their needs are being met. There is insufficient evidence to support this allegation.

Based on observations, interviews with staff and residents and record review, There is insufficient evidence to support the allegations.

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 Madeleine Sievert Administrator. A copy of this report along with the appeal rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4