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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 07/29/2025
Date Signed: 11/04/2025 01:37:28 PM

Substantiated


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
12/20/2024 and conducted by Evaluator Huma Rahimi
COMPLAINT CONTROL NUMBER: 31-AS-20241220150010
FACILITY NAME:SAVANT OF BURBANK EASTFACILITY NUMBER:
198603136
ADMINISTRATOR:ACHARYA, NIRJARAFACILITY TYPE:
740
ADDRESS:1900 GRISMER AVETELEPHONE:
(818) 843-3141
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY:100CENSUS: 93DATE:
07/29/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Imelda Villanueva, AdministratorTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff yelled at resident.
Staff did not maintain a comfortable environment for residents.
INVESTIGATION FINDINGS:
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This is an amended version of the original report issued on 07/29/2025. The amendment was made to correct the deficiency cited on form LIC 9099D and LPA conducted interview with five (5) additional residents. At 9:30 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced subsequent complaint visit. LPA was greeted by the front desk receptionist Karla Calemente and the Administrator was contacted. LPA met with the Administrator and explained the reason for the visit.

An initial complaint visit was conducted on 12/23/2024. At 10:20 AM, LPA requested client and staff roster. At 10:30 AM, LPA requested copies of pertinent information which include, but not limited to Physician’s Report, Admission Agreement, Appraisal Needs and Services Plan, etc., relevant to the investigation. At approximately 10:45 AM, LPA conducted a physical plant tour. Between 11:15 AM – 2:45 PM, LPA conducted an interview with the Administrator, Business Office Manager, Wellness Director, Wellness Coordinator, a MedTech, two (2) staff, and eight (8) out of twelve (12) residents who were able to communicate. Continue on LIC 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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 3
Control Number 31-AS-20241220150010
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 BURBANK EAST
FACILITY NUMBER: 198603136
VISIT DATE: 07/29/2025
NARRATIVE
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Staff yelled at resident:

It was reported that staff #1 (S1) yelled at Resident #1 (R1) when R1 was trying to close Resident #2 (R2) door to lessen the sound of R2’s screams. To investigate this allegation LPA conducted an interview with the Administrator and it was revealed that S1 is reported to be rude to some residents in care. Furthermore, LPA was informed that the facility is in the process of taking action to address S1’s conduct and performance. Additionally, interviews with Staff #2 (S2) and a MedTech confirmed the information provided by the Administrator. Moreover, LPA reviewed LIC 500 (Staff Roster) and observed that S1 is currently scheduled in the staff roster. Lastly, interviews with the residents confirmed S1 yelling at residents in care. Based on the information gathered through interviews this allegation is deemed Substantiated.

Staff did not maintain a comfortable environment for residents:

It was reported that Resident #2 (R2) is screaming/yelling incoherently creating uncomfortable environment to other residents in care. To investigate this allegation LPA conducted an interview with the Administrator, BOM, a MedTech, and two (2) staff and all parties interviewed admitted that R2 does scream when he/she needs assistance. Furthermore, interviews also revealed that R2 screams does create an uncomfortable environment to other residents. During the initial visit on 12/23/2025, LPA also heard R2 screaming extremely loud creating an uncomfortable environment. Moreover, LPA conducted a file review of R2 and did not observe that the facility either notified R2's Physician nor updated the Appraisal Needs and Services Plan to meet and address R2’s needs appropriately. Lastly, interviews with eight (8) out of twelve (12) residents also confirmed that R2 screams day and night, which makes the other residents uncomfortable. Based on interviews, record review, and LPA’s observation this allegation is deemed Substantiated.

Deficiencies issued and appeal rights explained and given.


Exit interview conducted and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20241220150010
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 BURBANK EAST
FACILITY NUMBER: 198603136
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/05/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in all Facilities (a) Residents in all residential care facilities for the elderly shall...(1) To be accorded dignity in their personal relationships with staff, ....
This requirement is not met as evidenced by:
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Licensee to conduct an in-service training to all staff on the cited section and issue a written notice to Staff #1 (S1)
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Based on interviews, the licensee did not comply with the section cited above by permitting Staff #1 (S1) to be disrespectful towards residents, which posed a potential Health, Safety, or Personal Rights risk to persons in care.
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Request Denied
Type B
08/05/2025
Section Cited
CCR
87468.1(a)(2)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable...... This requirement is not met as evidenced by:
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The Executive Director and staff already conducted a training on Personal Rights of Residents and LPA was provided a copy of the training and the POC is cleared during today's visit.
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Based on the observation and interviews
the Licensee did not comply with the section cited byexposing other residents to uncomfortable environment which was caused by R1's screaming/yelling which posed a potential Health, Safety, or Personal Rights risk to persons 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: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3