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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603597
Report Date: 11/25/2024
Date Signed: 11/25/2024 03:48:33 PM

Document Has Been Signed on 11/25/2024 03:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:SAVANT OF ALHAMBRAFACILITY NUMBER:
198603597
ADMINISTRATOR/
DIRECTOR:
PHAM, LISAFACILITY TYPE:
740
ADDRESS:1 E COMMONWEALTH AVETELEPHONE:
(626) 289-3871
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 176CENSUS: 128DATE:
11/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:14 PM
MET WITH:Madeleine Sievert, Acting Administrator. TIME VISIT/
INSPECTION COMPLETED:
03:46 PM
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Licensing Program Analyst (LPA) Alberto Lopez made an unannounced visit to inspect the dementia care section of the facility in order to approve facilities' request to advertise for dementia care. LPA met with Acting Administrator Madeleine (Maddie) Sievert and discussed the purpose of the visit.

LPA spoke with former Administrator Lisa Pham via phone and she reported to LPA that facility does not have a specific area for dementia care and will only be accepting early onset dementia residents.

LPA reviewed and obtained dementia training proof for all staff, and staff and resident rosters.

LPA took tour of facility with Maddie and observed the exit door leading to garage and front exit without any kind of alert system.

Maddie stated they will install the audio systems and send proof to LPA when complete.

LPA will review Dementia Plan submitted by facility and will address any issue that is missing with facility in order to approved the facility to advertise Dementia Care at Savant of Alhambra.


Exit interviewed conducted and copy of report provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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