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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603172
Report Date: 01/14/2025
Date Signed: 01/14/2025 09:43:44 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/27/2024 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241127131439
FACILITY NAME:SAVANT OF NORWALKFACILITY NUMBER:
198603172
ADMINISTRATOR:CHANEL A. SANCHEZFACILITY TYPE:
740
ADDRESS:11515 FIRESTONE BLVDTELEPHONE:
(562) 379-9200
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:80CENSUS: 77DATE:
01/14/2025
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Janice Anguiano Business Office ManagerTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff does not ensure residents personal belongings are properly secured
Staff altered residents medication
Staff do not ensure residents health care needs are being addressed
Staff does not ensure resident is accorded a safe living environment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Business Office Manager Janice Anguiano and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 12/05/2024, LPA interviewed Staff #1- Staff #8, Residents #1 -Residents #8, and checked R1’s medication for any errors or discrepancies. LPA obtained copies of the following documents: Staff roster, Resident roster, R1’s preplacement appraisal information, Physicians reports, orders for medication and facility notes.

SEE LIC 9099C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
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 28-AS-20241127131439
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SAVANT OF NORWALK
FACILITY NUMBER: 198603172
VISIT DATE: 01/14/2025
NARRATIVE
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In regard to the allegation” Staff does not ensure residents personal belongings are properly secured”, it is alleged that staff are taking personal possessions from room. During interviews with residents six (6) out of eight (8) stated they never had any personal items missing from there rooms. R1 stated that staff keeps taking socks R8 stated fifty dollars was missing and once reported staff gave him/her a lock for a drawer. During interviews with staff seven (7) out of eight (8) staff stated they have never heard items were missing from residents’ rooms. S6 stated “They get a key for a nightstand in their room if they ask for one. I am in charge of giving them one. They sometimes say there belong are gone. Like they lose the key, but they find it later”.

In regard to the allegation “Staff altered residents’ medication”, it is alleged that staff are putting water in prescription eye drops. During interviews with residents six (6) out of eight (8) stated that they have no problems with medications given to them by staff. R1 stated “they used to give me eye drops. First one was good now these are water and salt. They threw them away”. LPA Gutierrez checked medication for R1 and eyedrops were in original bottle from pharmacy. R8 stated medication were sometimes late. During interviews with staff eight (8) out of eight (8) stated that facility does not alter medication. S8 stated that R1 sometimes refuses medication and that they have had psychiatric doctor to evaluate resident.

In regard to the allegation “Staff do not ensure residents health care needs are being addressed”, it is alleged that facility staff are not addressing residents’ health concerns or assisting with making appointments with physician. During interviews with residents seven (7) out of eight (8) residents stated that facility will assist them with any medical needs that may arise. R1 stated “I see the doctor every week this doctor doesn’t know what he is doing”. During interviews with staff eight (8) out of eight (8) staff state facility always addresses the residents needs and assists with making doctor appointments. S3 states” We sometimes ask them if they want to go to hospital and they refuse. They say pills.”

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20241127131439
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SAVANT OF NORWALK
FACILITY NUMBER: 198603172
VISIT DATE: 01/14/2025
NARRATIVE
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In regard to the allegation “Staff does not ensure resident is accorded a safe living environment” it is alleged that residents don’t feel safe. During interviews with residents seven (7) out of eight (8) residents stated they feel safe at the facility. R1 does not feel safe because his/her socks are being taken by staff. During interviews with staff eight (8) out of eight (8) state the facility is safe for residents and staff. S8 stated “If it wasn’t safe I wouldn’t be becoming back’.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was given to Janice Anguiano.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3