198320378-6-18-2025-11-AS-SCIS-DJZUYK-20250728160001

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 06/18/2025
Date Signed: 06/18/2025 11:11:18 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/15/2025 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 11-AS-20250415095739

FACILITY NAME:	SAVANT OF SANTA MONICA		FACILITY NUMBER:	198320378
ADMINISTRATOR:	NATHANIEL VENZON		FACILITY TYPE:	740
ADDRESS:	1447 17TH STREET		TELEPHONE:	(310) 829-5904
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90404
CAPACITY:	174	CENSUS: 101	DATE:	06/18/2025
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Nathaniel Venzon-Administrator		TIME COMPLETED:	11:23 AM

ALLEGATION(S):

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Staff did not respond to resident's call for assistance

INVESTIGATION FINDINGS:

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***This report supersedes the original report delivered on 4/23/2025. On 6/18/2025,LPA Allen arrived at the facility to deliver the corrected 9099, providing clarification on the original report issued on 04/23/2025. *** LPA met with Nathaniel Venzon- Administrator who was informed of the purpose of the visit.

On 4/23/2025, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to initiate and deliver findings for the alleged allegation. LPA identified herself and met Brooke Lamotte- who was informed of the purpose of the visit.

The investigation consisted of the following:

At 9:30 AM, LPA Allen reviewed resident 1 (R1) file, face sheet, pre-placement appraisal dated 9/5/2024,physicians report dated 9/11/2024, admissions agreement dated 12/2/2024, notes/logs dated 4/1/2025- 4/23/2025. LPA also requested and reviewed the following documents: Staff roster (LIC 500), shift schedule for 4/1/2025 - 4/15/2025 continued ...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025

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 11-AS-20250415095739

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SAVANT OF SANTA MONICA	FACILITY NUMBER: 198320378
	VISIT DATE: 06/18/2025

NARRATIVE

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resident roster and LPA Allen conducted interviews with staff 1- staff 10 (S1 - S10), resident 1- resident 9 (R1- R9).
The investigation revealed the following:

Allegation: Staff did not respond to resident's call for assistance

At 11:30 AM, LPA Allen interviewed ten (10) staff members staff 1- staff 10 (S1 - S10) of those interviewed 10 out of 10 staff stated they are informed by the concierge on duty by portable two-way radios of the resident requiring assistance. Assistance is provided in a timely manner which can range between 5-10 minutes. Staff also stated if there are staffing issues residents wait time can be between 5-15 minutes, however staff members communicate with each other to ensure residents are acknowledged as needing help and given an estimated wait time to insure assistance is provided.

The interview with Brooke Lamotte- Wellness Director stated there are some staffing concerns which have been addressed by having a job fair on 4/22/2025 and they expect to have eight (8) additional care staff members and three (3) MedTech’s with estimated start dates of May 1, 2025. LPA Allen also observed the 11 potential new hire roster/schedule.

At 1:15 PM, LPA Allen interviewed resident 1- resident 9 (R1- R9) of those interviewed, 1 out of 9 residents stated they did not get assistance when they used their call button which happened on one occasion. The interviews with the remaining 8 residents stated help is received when they use their call buttons, however they also stated on occasion it may take longer than usual for staff to come assist them, but assistance is provided which they believe is because of staffing issues.

LPA Allen also toured the facility including five (5) rooms and observed call buttons to be in operable condition and observed residents getting assistance when their call buttons were used.

Based on LPA’s observation, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted where this report was discussed and provided to Nathan Venzon at the conclusion of the visit with appeal rights.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025

LIC9099 (FAS) - (06/04)

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