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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 06/28/2024
Date Signed: 06/28/2024 01:41:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/21/2024 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20240621110324
FACILITY NAME:GARDEN OF PALMS LAFACILITY NUMBER:
197610403
ADMINISTRATOR:HIRSCH,RENAFACILITY TYPE:
740
ADDRESS:1025 N FAIRFAX AVETELEPHONE:
(323) 656-7900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:130CENSUS: 109DATE:
06/28/2024
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Adam SyncheffTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Licensee/Administrator made misleading representation of the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced complaint visit to the facility to investigate the above allegations at 10:45 am. LPA met with the administrator Adam Syncheff and disclosed the purpose of the visit.
LPA Smith conducted interview with staff two (2), reviewed facility files, and request documents relevant to the investigation between 11:00- 1:20 pm.

Licensee/Administrator made misleading representation of the facility It was alleged that the licensee/administrator made misleading representation of the facility. and the facility Garden of Palms LA is operating as Savant. Details of the complaint reveal staff are representing themselves as employees of Savant, wearing T-shirts advertising Savant Senior Living. Licensing Program Manager (LPM) Naira Margaryan called the facility and the reception staff responded to the call stating, "Savant West Hollywood - How can I help you"? during complaint intake to collect additional information. During a previous visit to the facility
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
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 31-AS-20240621110324
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: GARDEN OF PALMS LA
FACILITY NUMBER: 197610403
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/03/2024
Section Cited
CCR
87207
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No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility of any of the services provided by the facility. This requirement was not met:
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The Licensee will contact LPA to discuss plan of correction.
POC due date:07/03/24
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Based on observation and interviews the Licensee changed name and singage to building without following appropriate protocol with the CCLD. This poses a potential risks to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20240621110324
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GARDEN OF PALMS LA
FACILITY NUMBER: 197610403
VISIT DATE: 06/28/2024
NARRATIVE
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(cont from 9099)

conducted by LPA Tihesha Smith on 06/16/2024 unrelated to current complaint LPA observed the signage on the building was rename from Gardens of Palm LA to Savant West Hollywood Senior Living. During today’s visit LPA observed staff in Savant shirts and folders bearing the Savant name. Interview with the administrator revealed that the name change was handled at the corporate level. The vice president of the facility was contacted by the administrator via telephone. interview with the vice president of operations for the facility revealed the name change paperwork is drafted but waiting for signatures from the Chief Executive Officer of the company and has not been sent to the Licensing Department for initial review and approval.

Based on interviews, there is sufficient evidence to support the allegation Licensee/Administrator made misleading representation of the facility. Therefore, the allegation is deemed SUBSTANTIATED at this time.

Deficiency cited on 9099D

Exit interview conducted/Copy of report given.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4