335530032-12-5-2024-56-AS-KCLS-DC3QMP-20241218111751

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 09/19/2024
Date Signed: 12/05/2024 02:15:14 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
09/16/2024 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240916230721

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:	09/19/2024
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Danielle Garcia, Office Manager		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff used a resident's bathroom
Staff does not prevent a resident from smoking in their room

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived at the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Danielle Garcia, Office Manager, and explained the elements of the complaint.Allegation #1: The facility had the water shut off on 09/06/2024 for a two-hour period. Notices were given to all residents, and LPA Prieto obtained a copy of this notice. Kitchen staff were informed to ensure that meals could be prepared and served without interruption. Residents were advised to use the restroom only once until water service was restored. Staff were instructed to use the staff bathrooms located throughout the facility. During interviews, Staff #1 (S1), S2, S3, and S4 confirmed that they do not use the residents' restrooms. Additionally, S2 mentioned that their work crew does not use any residents' restrooms.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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-20240916230721

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: 09/19/2024

NARRATIVE

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Allegation #2: LPA Prieto interviewed Resident #1 (R1), who was alleged to have been smoking in their room. R1 denied smoking in their room. The facility's policy, which prohibits smoking in any section of the community, including apartments, is clearly posted in the facility lobby and included in each resident's admissions agreement.

Based on the information obtained, there is insufficient evidence to support the allegations that staff used a resident's bathroom or that staff failed to prevent a resident from smoking in their room. Therefore, these allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Office Manager Garcia, and a copy was left with the facility.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC9099 (FAS) - (06/04)

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