335530032-6-24-2024-56-AS-EMAN-D6KTQR-20240625145621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 06/24/2024
Date Signed: 06/24/2024 11:19:48 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/26/2024 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240226145618

FACILITY NAME:	SAVANT OF JURUPA VALLEY		FACILITY NUMBER:	335530032
ADMINISTRATOR:	PATRICK L. MCADOO-MORTON		FACILITY TYPE:	740
ADDRESS:	5881 EL PALOMINO DRIVE		TELEPHONE:	(951) 683-3333
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92509
CAPACITY:	197	CENSUS: 155	DATE:	06/24/2024
		ANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Executive Director Patrick McAdoo-Morton		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Staff did not fix the running water timely.

INVESTIGATION FINDINGS:

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On 06/24/2024 at 11:05 AM, Licensing Program Analyst (LPA) Melody Brown met with Executive Director Patrick McAdoo-Morton at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) Regional Office to deliver the findings of the above allegation. LPA Brown explained the purpose of the requested Office Visit. The investigation consisted of observation, interviews and a review of pertinent documentation.

The investigation was conducted by LPA Melody Brown. The investigation consisted of records review and interviews with relevant parties. The allegation indicates Staff did not fix the running water timely. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with seven (7) of eight (8) residents indicated that staffs at the facility fixed the running water issue timely. Interviews with five (5) of five (5) staffs indicated that staffs at the facility immediately contacted the plumbing company to addressed the issue and immediately notified its residents, family members and responsible parties. Residents and staffs interviews revealed that the facility distributed *** Continuation on LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20240226145618

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: SAVANT OF JURUPA VALLEY	FACILITY NUMBER: 335530032
	VISIT DATE: 06/24/2024

NARRATIVE

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gallons of water to their residents to ensure all their residents have water supply. Per documents review, LPA Brown observed the ED McAdoo-Morton immediately address the issue as ED McAdoo-Morton contacted a plumbing company to report the sewer issue at the facility. During the facility visit on 02/29/2024, LPA Brown observed gallons of water on resident rooms.

Based on the evidence, the allegation that Staff did not fix the running water timely is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means 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 at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to Executive Director Patrick McAdoo-Morton.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

LIC9099 (FAS) - (06/04)

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