335530032-7-22-2025-56-AS-NBRN-DKBSVF-20250807141242

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 07/22/2025
Date Signed: 07/22/2025 04:46:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/30/2024 and conducted by Evaluator Renese Howell-Small

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240530145847

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: 144	DATE:	07/22/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Marc Pacia		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff left resident in a dirty diaper for extended periods
Staff did not ensure to accommodate resident
Staff did not ensure to keep resident’s room clean
Staff did not meet resident’s hygiene needs
Staff did not ensure to assist resident with transferring from bed to wheelchair and vice versa
Staff did not ensure that resident had eaten food

INVESTIGATION FINDINGS:

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On 07/22/2025 at 9:00AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA discussed the purpose of the visit with Executive Director, Marc Pacia. The investigation consisted of interviews, record review and observation.

In regards to the allegation that staff left resident in a dirty diaper for extended periods:
LPA interviewed seven (7) staff and ten (10) residents. Staff stated that residents are assisted with their changing needs based upon their needs and services plan and as needed. Staff denied the allegation and confirmed that residents are checked every two (2) hours and they also have a call button/pendant that can be used to call for assistance. Residents stated that their call buttons work and staff assist them with diapering needs when needed. The facility does not provide diaper supplies for residents, these are supplied by family or residents' insurance. Based on interviews, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not ensure to accommodate resident:
LPA interviewed seven (7) staff and they stated that residents are provided with assistance based upon their needs and services. Resident 1 (R1) ambulated with a wheelchair and was placed on the first (1) level of the facility. Per the Admission's Agreement, staff assisted R1 with baths and toileting, medications and dressing. Staff denied the allegation. The residents interviewed stated that staff assist them with what is needed. Based upon interviews, this allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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-20240530145847

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: SAVANT OF JURUPA VALLEY	FACILITY NUMBER: 335530032
	VISIT DATE: 07/22/2025

NARRATIVE

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In regards to the allegation of staff did not ensure to keep resident’s room clean:
LPA interviewed seven (7) staff and ten (10) residents. Staff stated that rooms are cleaned once a week or more if needed. The facility provided a staff schedule indicating which staff were assigned to clean which rooms and noted if residents refused the service. All ten (10) of residents interviewed stated that their rooms are cleaned often. LPA observed several rooms during the visit to be sanitary. Based upon interviews and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not meet resident’s hygiene needs:
LPA interviewed seven (7) staff. Caregiving staff assist with resident's hygiene needs and stated that some residents need more assistance than others. The facility does not provide a shower chair but does offer bed baths for residents who can not be assisted safely in the shower. All ten (10) of the residents stated that staff assist them with their hygiene needs or they do so independently.
Based upon interviews, this allegation is UNSUBSTANTIATED.

In regards to the allegation of staff did not ensure to assist resident with transferring from bed to wheelchair and vice versa :
LPA interviewed seven (7) staff. Staff indicated that they are trained to safely transfer residents and assist the residents with transferring as needed. Staff assist with transfers based upon the resident's routine. Residents stated that if they need assistance with transferring or being escorted, staff assists them. Based upon interviews, this allegation is UNSUBSTANTIATED.

In regards to the allegation that staff did not ensure that resident had eaten food:
Based upon interviews with staff, staff stated that residents are either escorted to the dining area, independently ambulate or are offered meal service. The Admission's Agreement indicates that three meals and snacks are provided. Residents stated that they have their meals in the dining room, are escorted or may have the option of a sack lunch. Staff stated that caregivers will note if a resident is not in the dining area and will request a meal service or a sack lunch for the resident. Based upon interviews, this allegation is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where this report LIC9099 and LIC9099C was discussed and a copy was provided to Executive Director, Marc Pacia.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

LIC9099 (FAS) - (06/04)

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