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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320378
Report Date: 10/28/2025
Date Signed: 10/28/2025 03:11:02 PM

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
10/21/2025 and conducted by Evaluator Felisa Shirley
COMPLAINT CONTROL NUMBER: 11-AS-20251021095038
FACILITY NAME:SAVANT OF SANTA MONICAFACILITY NUMBER:
198320378
ADMINISTRATOR:NATHANIEL VENZONFACILITY TYPE:
740
ADDRESS:1447 17TH STREETTELEPHONE:
(310) 829-5904
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY:174CENSUS: 130DATE:
10/28/2025
UNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Brooke LoMotte, Wellness DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff are not allowing residents to reject medical services when a threat is not imminent
INVESTIGATION FINDINGS:
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On 10/28/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Wellness Director, Brooke LaMotte and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:
On 10/28/25 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, Plan of Operations, “Handling of Medical Emergencies,” Face Sheet, R-1’s Service Plan, Medication Reconciliation form, Resident Appraisal, Medical Assessment for Residential Care Facilities for the Elderly. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff-8 (S1 – S8), and Resident -1 – Resident -10 (R1-R10).

The investigation revealed the following:
Con'd on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
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 2
Control Number 11-AS-20251021095038
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: 10/28/2025
NARRATIVE
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Allegation: Facility staff are not allowing residents to reject medical services when a threat is not imminent

It is being reported that R-1 was adamant about not needing emergency medical services. LPA Shirley reviewed incident report dated 10/26/25 with an occurrence date of 10/19/25, stating that R1 slipped and fell while entering the elevator and struck her head. R1 had visible bruising and stated she had a headache. During interviews on 10/28/25, S-2 stated that staff follows required handling of medical emergencies which includes assessing the resident and calling 911 if needed. On 10/28/25, LPA Felisa Shirley reviewed the Plan of Operation observed that procedures for medical emergencies are being followed.

LPA interviewed staff 1 – staff 8 (S-1 – S-8). Of those interviewed 5 out of 8 denied the allegation, 3 did not know. LPA interviewed resident 1 – resident 10 (R1 – R10). Of those who interviewed 10 out of 10 denied the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation, “Facility staff are not allowing residents to reject medical services when a threat is not imminent,” therefore, the allegation is unsubstantiated.

No deficiencies were cited for these allegations.

An exit interview was conducted and a copy of this report was provided to the Wellness Director, Brooke LaMotte.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2