331881480-7-26-2025-18-AS-KBUY-DK42JU-20250730172656

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881480
Report Date: 07/26/2025
Date Signed: 07/26/2025 09:49:45 AM

Unsubstantiated

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
08/21/2024 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 18-AS-20240821141334

FACILITY NAME:	SAVANT OF RIVERSIDE		FACILITY NUMBER:	331881480
ADMINISTRATOR:	MOLLY BOWIE		FACILITY TYPE:	740
ADDRESS:	4609 ARLINGTON AVE		TELEPHONE:	(951) 462-1025
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	232	CENSUS: 100	DATE:	07/26/2025
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Edgar Mendez		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has bed bugs
Resident was forced to relocate due to bed bugs

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Emily Peraldi conducted a subsequent complaint visit to deliver final findings for the above allegations. During today’s visit, LPA Peraldi met with the Culinary Manager, Edgar Mendez and explained the reason for the visit.

On 08/21/2024, the Riverside Adult and Senior Care Regional Office (RO) received a complaint regarding physical plant and personal rights violations. The complaint alleged that the facility and bedroom of Resident #1 (R1) had bed bugs and that R1 was forced to relocate rooms due to bed bugs.

Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2025

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-20240821141334

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: 07/26/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 08/23/2024, from 2:45pm to 3:45pm, Licensing Program Analyst (LPA), Kathleen Banrasavong, conducted an unannounced visit to the facility to initiate the investigation of the allegations listed above. LPA Banrasavong met with the Executive Director/Administrator Molly Bowie and informed her of the purpose of the visit. The LPA conducted a tour of the interior/exterior areas of the facility, conducted a review of records, and requested copies of pertinent documentation. The LPA interviewed residents and staff. The Executive Director/Administrator was advised that further investigation was needed prior to issuing findings.

According to the Executive Director/Administrator, the facility has an ongoing contract with pest control company Orkin to provide routine services to prevent pests. Administrator stated there have been some instances where pests/bed bugs have popped up and they immediately address with the pest control company. The Administrator provided copies of Orkin service reports for service dates of 07/26/2024, 08/09/2024, 08/21/2024, 08/23/2024, 08/26/2024 and 08/27/2024. The administrator also provided the facility protocol for bed bugs and copies of the 08/21/2024 and 08/23/2024 incident reports submitted to Community Care Licensing (CCL). The incident reports document bed bugs were found in R1’s room and four other resident rooms. R1 refused to be temporarily relocated while R1’s room was treated; the other residents were relocated to temporary room assignments while the rooms were treated. R1 no longer resides at the facility. R1 moved out of the facility on 11/18/2024. An attempt to contact R1 was made, however, the phone number was not valid.

The facility has demonstrated a proactive approach to pest management and is under a standing contract with Orkin to conduct semi-monthly services to help ensure the facility remains free of infestations. The Department’s investigation did not provide sufficient evidence to substantiate the allegations, therefore the above allegations are deemed Unsubstantiated at this time.

Exit interview conducted and copy of report issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2