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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881480
Report Date: 01/16/2025
Date Signed: 01/16/2025 09:09:49 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/17/2024 and conducted by Evaluator Armando Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20241217150653
FACILITY NAME:SAVANT OF RIVERSIDEFACILITY NUMBER:
331881480
ADMINISTRATOR:MOLLY BOWIEFACILITY TYPE:
740
ADDRESS:4609 ARLINGTON AVETELEPHONE:
(951) 462-1025
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:232CENSUS: DATE:
01/16/2025
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Business Office Manager Crystal MaldonadoTIME COMPLETED:
09:20 AM
ALLEGATION(S):
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Staff are not allowing resident to return to the facility due to their stage 4 pressure injury
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA met with Business Office Manager Crystal Maldonado, where the LPA explained the purpose of the visit and the elements of the allegation. The investigation consisted of observations, interviews with staff members and residents, and a review of records.

On December 17, 2024, Community Care Licensing received a complaint alleging that staff are not allowing resident to return to the facility due to their stage 4 pressure injury. It was reported that the resident was not allowed to return to the facility until the pressure injury was downgraded to stage 2 or 3. Information obtained from interview with Administrator stated that the level of care for stage 4 pressure injury was a restricted health condition and would require hospice enrollment for the additional care. This is in accordance with Title 22 regulations. Information obtained from interview with the resident stated that they were not denied returning back to the facility, but was registered for hospice care for the care of the stage 4 pressure injury.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
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 18-AS-20241217150653
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SAVANT OF RIVERSIDE
FACILITY NUMBER: 331881480
VISIT DATE: 01/16/2025
NARRATIVE
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Additionally, LPA observed resident to be living at the facility during the visit on December 23, 2024 and obtained a Hospice Admissions letter from Hospice of the IE and OC dated December 20, 2024.

Based on interviews, research, and record review, the allegation that staff are not allowing resident to return to the facility due to their stage 4 pressure injury is unfounded. A finding that the allegation is unfounded meaning that the allegation was false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted where a copy of this report was provided to Business Office Manager Crystal Maldonado.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2