197610403-9-9-2025-31-AS-TAGD-DPHPVP-20251219103928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 09/09/2025
Date Signed: 09/09/2025 02:54:19 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
07/29/2025 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20250729123022

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: 107	DATE:	09/09/2025
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Abbygaile Macaso		TIME COMPLETED:	02:49 PM

ALLEGATION(S):

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Facility staff do not respond to call bell in a timely manner.
Facility staff are not adhering to resident care plan.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Abbygaile Macaso and explained the reason for the visit.

---Facility staff do not respond to call bell in a timely manner.

It was alleged that Resident #1’s (R1) pressed the call button and R1’s responsible party called the facility to assist R1 but the caregiver arrived fifty-five (55) minutes later. To investigate the allegation, on 08/06/2025 LPA conducted a physical plant tour at around 11:00a.m. LPA interviewed four (04) staff from 12:00p.m. to 1:30p.m. and ten (10) residents from 1:30p.m. to 3:00p.m. During physical plant tour, LPA observed a working call button and an average response time of four (04) minutes. During interviews with staff, all staff stated the average response time is five (05) minutes.
(CONT on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

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 31-AS-20250729123022

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: 09/09/2025

NARRATIVE

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Staff #1 (S1) added that on the evening in question, R1 needed a two (02) person assist to transfer so R1 waited approximately ten (10) to fifteen (15) minutes for the additional staff. During interviews with residents, eight (08) out of ten (10) stated staff respond to call button in a timely manner and the remaining two (02) stated staff take an extended time to respond to call buttons.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Facility staff are not adhering to resident care plan.

It was alleged that R1 often receives items like lettuce that R1 cannot eat and staff fail to cut up R1’s food as specified in the care plan. To investigate the allegation, on 08/06/2025 LPA conducted a physical plant tour and requested documents at around 11:00a.m. LPA interviewed four (04) staff from 12:00p.m. to 1:30p.m. and ten (10) residents from 1:30p.m. to 3:00p.m. A review of R1’s Needs and Service Plan states in part that R1’s food is to be served cut, deboned and free from mixed fresh vegetables. During physical plant tour, LPA observed R1’s lunch which was according to the agreed upon care plan. The food was cut up, deboned and LPA did not observe mixed vegetables on the plate. LPA also observed special laminated posters throughout the kitchen notifying kitchen staff of R1’s preferences. During interviews with staff, all staff stated they follow the food plan as agreed upon with R1’s responsible party. Staff #2 (S2) added they are trying their very best to accommodate all of R1’s requests. During interviews with residents, all residents stated they feel facility is following care plan.

Based on observations, record review and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of the report issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

LIC9099 (FAS) - (06/04)

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