197610403-4-28-2025-31-AS-NGID-DL7T5Z-20250904142620

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 04/28/2025
Date Signed: 04/28/2025 02:33:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
03/18/2025 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20250318132449

FACILITY NAME:	SAVANT OF WEST HOLLYWOOD		FACILITY NUMBER:	197610403
ADMINISTRATOR:	ADAM SYNCHEFF		FACILITY TYPE:	740
ADDRESS:	1025 N FAIRFAX AVE		TELEPHONE:	(323) 656-7900
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	130	CENSUS: 104	DATE:	04/28/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Adam Syncheff		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff are not following resident's doctor recommended dietary needs-
Staff are not meeting resident's bathing needs-
Resident's call button is in disrepair-
Staff do not treat resident with dignity and respect-
Facility did not comply with reporting requirements-

INVESTIGATION FINDINGS:

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At 10:00 am, Monday, 4/28/25, Licensing Program Analyst, (LPA) Raymond Comer, arrived to conduct a subsequent visit regarding the allegation(s) listed above. LPA conducted the initial complaint visit on 3/28/25. LPA met with facility Administrator, Adam Syncheff, presented official CDSS badge identification, and reason for the visit was disclosed.

At 10:10 am, LPA conducted a physical plant tour; no health and safety issues were observed.

To investigate the allegation, LPA received Facility resident roster, and staff roster. At 10:35 am, LPA recieved and reviewed Resident 1's (R1) file. LPA also conducted interviews with the Administrator, Staff and Residents.

[LIC 9099C] Continued-

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

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-20250318132449

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF WEST HOLLYWOOD	FACILITY NUMBER: 197610403
	VISIT DATE: 04/28/2025

NARRATIVE

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Allegation: Staff are not following resident's doctor recommended dietary needs- The reporting party (RP) alleges that Resident#1 (R1) is not consistently offered a water-diluted juice beverage, and that the only meal substitutions offered to R1 are peanut butter and jelly sandwiches and eggs, which RP states are not healthy nutritional options as R1 is a diabetic.
LPA interview with Food Service Staff and Administrator revealed the following: Both Admin and S1 refute this allegation, stating that R1 is offered, fish, hamburger, salads, and fresh fruit as meal alternatives. S1 states that a diluted juice beverage is consistently made available, and is offered to R1 a minimum of every two hours.
A tour of R1's room by LPA revealed the following: LPA observed two cups of a water-diluted juice drink placed on a small table accessible to R1, and that a drink pitcher filled with the diluted juice beverage was observed in R1's small refrigerator.
LPA interviews with ten (10) out of one hundred and four (104) total facility residents revealed the following: Nine (9) out of ten (10) residents interviewed confirm their satisfaction with the food and drink provided by staff to residents while in care.

Based on the information obtained, there is insufficient evidence to corroborate the allegation that staff are not following doctor recommendations regarding R1's dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Staff are not meeting resident's bathing needs- The reporting party (RP) alleges that Staff neglect to provide Resident#1 (R1) with showering/bathing assistance, stating that R1 hasn't been bathed in several weeks.
LPA interview with caregiver staff revealed the following: S3 refutes this claim, stating that on the morning of today's LPA visit, R1 had showered, with the assistance of caregiver staff. S3 stated to LPA that "R1 does not like washing up and sometimes yells at us to go away". S3 states that when R1 refuses staff assistance with showering/bathing, it is reported to med tech staff, who then contact the responsible family member.
LPA interview with the responsible family member (F1) revealed the following: F1 confirmed to LPA that R1 does not like taking showers and gets agitated by/aggressive with caregiver staff when offered their assistance with this task. However, F1 states they are contacted by staff requesting F1 to encourage R1 to accept staff assistance with showering/bathing tasks.
A tour of R1's room by LPA revealed the following: LPA observed R1 sitting in a recliner chair, wearing clean and dry clothing. LPA observed R1 as clean and having no odor.
[LIC 9099C] Continued-

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20250318132449

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF WEST HOLLYWOOD	FACILITY NUMBER: 197610403
	VISIT DATE: 04/28/2025

NARRATIVE

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LPA interviews with ten (10) out of one hundred and four (104) total facility residents revealed the following: Ten (10) out of ten (10) residents interviewed confirm their satisfaction with the showering/bathing assistance provided by staff to residents while in care.

Based on the information obtained, there is insufficient evidence to corroborate the allegation that staff are not meeting R1's bathing needs. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Resident's call button is in disrepair- The reporting party (RP) alleges that Resident#1 (R1's) room call button is detached from the wall.
LPA interview with caregiver staff revealed the following: Both the facility Administrator and S3 refute this claim, stating that, on some occasions, R1 will change positions in his recliner chair, which causes the cord to detach. Per staff, during periodic room well checks, staff with observe and reattach the cord to the wall.
A tour of R1's room by LPA revealed the following: Both call button assistance cords in R1's room (located by R1's recliner chair and by R1's bed) were attached, tested by the LPA, and found to be functioning properly.
LPA interviews with ten (10) out of one hundred and four (104) total facility residents revealed the following: Ten (10) out of ten (10) residents interviewed confirmed their room's call button functioned properly.

Based on the information obtained, there is insufficient evidence to corroborate the allegation that R1's call button is in disrepair. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Staff do not treat resident with dignity and respect- The reporting party (RP) alleges that as he was speaking to the main medical technician, a staff colleague standing next to the med tech began laughing as the RP was speaking. Per the RP, they felt that the staff was laughing at them, which they felt was being rude and disrespectful to both R1 and the RP.
LPA interview with caregiver staff revealed the following: S4 refutes this claim stating she recalls the situation, and informed LPA that the incident was a misunderstanding. S4 states their colleague was not a participant in the conversation and was merely, "laughing about something she was listening in her earpiece which was covered by her hair".
LPA interview with RP revealed the following: RP confirmed to the LPA that he had never witnessed undignified conduct committed upon R1 by staff, and felt disrespected himself by the laughing staffer.
[LIC 9099C] Continued-

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20250318132449

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF WEST HOLLYWOOD	FACILITY NUMBER: 197610403
	VISIT DATE: 04/28/2025

NARRATIVE

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LPA interviews with ten (10) out of one hundred and four (104) total facility residents revealed the following: Nine(9) out of ten (10) residents interviewed confirm that staff treat them with dignity and respect.

Based on the information obtained, there is insufficient evidence to corroborate the allegation that staff do not treat R1 with dignity and respect. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Staff did not comply with reporting requirements- The reporting party (RP) alleges that on 12/06/24 Resident#1 (R1) was transferred out of the facility on a "5150" hold due to aggressive behavior committed by R1 upon caregiver staff. However, the RP states that, as a responsible family member, they were not informed of R1's transfer in a timely manner.
LPA interview with both the Administrator and S4 revealed the following: Both the facility Administrator and S4 refute this claim, stating that, on 12/06/24, Responsible Family Member for R1 was contacted, informed of R1's transfer, and and reason why the transfer was necessary for staff/resident safety.

Based on the information obtained, there is insufficient evidence to corroborate the allegation that staff failed to comply with reporting requirements. Therefore, the allegation is deemed Unsubstantiated at this time.

An exit interview was conducted, and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

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