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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 04/29/2024
Date Signed: 04/29/2024 04:43:20 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/24/2024 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240424104303
FACILITY NAME:SAVANT OF JURUPA VALLEYFACILITY NUMBER:
335530032
ADMINISTRATOR:PATRICK L. MCADOO-MORTONFACILITY TYPE:
740
ADDRESS:5881 EL PALOMINO DRIVETELEPHONE:
(951) 683-3333
CITY:RIVERSIDESTATE: CAZIP CODE:
92509
CAPACITY:197CENSUS: 158DATE:
04/29/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Danielle Garcia, Officer ManagerTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff opened resident's luggage without permission
Staff changed resident's doctor without permission
Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegations. LPA Prieto met with Danielle Garcia, Officer Manager, and discussed the elements of the complaint. LPA interviewed staff, resident in question, gathered pertinent documentation.

Regarding the allegation that staff opened resident's luggage without permission: Resident #1 (R1) in question states that the luggage was sealed with a small padlock and opened in R1's presence and no attempts to stop staff from cutting the lock. Interviews with staff #1 (S1) and S2 state the lock that was cut was to a lockbox, and cut per R1's request, in the presence of R1, which revealed R1's medication.
***continued on LIC 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024
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 56-AS-20240424104303
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: SAVANT OF JURUPA VALLEY
FACILITY NUMBER: 335530032
VISIT DATE: 04/29/2024
NARRATIVE
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 R1 added that luggage was opened to retrieve important documents and could not locate the lock's key. Staff added that R1 did not asked to open the luggage, but lockbox with medications.

Regarding the allegation that staff changed resident's doctor without permission; R1 was interviewed and states that R1 still has that same doctor and facility staff has not attempted to change her current Physician or medical insurance. Staff #3 (S3) confirmed that R1 continues to have the same Physician and insurance.

Regarding the allegation that staff spoke inappropriately to resident; R1 was interviewed and stated that words were said by R1 in a "heated moment". Staff #4 (S4) stated that R1 stated their issues with the facility and S4 stated the options needed to assist, one being to move to another facility as that option was available.

Based on the information obtained there is not enough evidence that staff opened resident's luggage without permission, staff changed resident's doctor without permission and staff spoke inappropriately to resident . Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Office manager Garcia and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2