335530032-8-9-2024-56-AS-EMAN-D84UHM-20240813153607

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 08/09/2024
Date Signed: 08/09/2024 12:38:13 PM

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
02/27/2024 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240227125022

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: 158	DATE:	08/09/2024
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Executive Director Maryann Nevarez		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff are not safeguarding resident's personal belongings.
Staff confiscated resident's vitamins.
Facility did not ensure that resident was transported to a medical appointment.

INVESTIGATION FINDINGS:

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On 08/09/2024 at 11:40 AM, Licensing Program Analysts (LPAs) Melody Brown and Raquel Hernandez conducted an unannounced visit to the facility to deliver the findings of the complaint investigations. LPAs Brown and Hernandez were greeted and granted entrance to the facility at the reception area by a staff. Executive Director (ED) Maryann Nevarez was informed of the visit and met with LPAs Brown and Hernandez. LPAs Brown and Hernandez explained the purpose of today's visit.

The investigation was conducted by LPA Brown. The investigation consisted of file review and interviews with relevant parties. The first allegation indicates Staff are not safeguarding resident's personal belongings. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with eight (8) of thirteen (13) residents indicated that staffs at the facility are safeguarding residents personal belongings. Interviews with five (5) of five (5) staffs indicated staffs are safeguarding residents personal belongings. Staffs are making sure residents rooms were locked. Per documents review, LPA Brown observed that the facility has Theft Loss Procedures in placed. *** Continuation in 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: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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-20240227125022

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: 08/09/2024

NARRATIVE

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During the facility visit on 06/17/2024, LPA Brown observed that staff at the facility are keeping the resident rooms locked if they are not in their room to keep their belongings safe.

The second allegation indicates that Staff confiscated resident's vitamins. Interviews with twelve (12) of thirteen (13) residents indicated that staffs at the facility are not confiscating their medications or vitamins. Interviews with five (5) of five (5) staffs indicated staffs are are not confiscating residents vitamins except if the resident is on medication management and the medications or vitamins in a resident room does not have a doctors order. Per review of Resident #1 (R1) Medication Administration Record (MAR), LPA Brown observed that R1's vitamins reported do not have doctors order.

The third allegation indicates that Facility did not ensure that resident was transported to a medical appointment. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with twelve (12) of thirteen (13) residents indicated that staffs at the facility are ensuring that they are transported to a medical appointment. Interviews with five (5) of five (5) staffs indicated resident was transported to a medical appointment. Interviews with staffs revealed that no incident happened at the facility that a staff did not ensure that a resident was transported to a medical appointment.

Based on interviews and records review, the allegation Staff are not safeguarding resident's personal belongings (Allegation #1), Staff confiscated resident's vitamins (Allegation #2) and Facility did not ensure that resident was transported to a medical appointment (Allegation #3) are UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, where this report (LIC9099) was discussed and provided to Executive Director Maryann Nevarez.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody Brown	TELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

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