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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 06/19/2024
Date Signed: 06/19/2024 03:36:02 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
06/18/2024 and conducted by Evaluator Javier Prieto
COMPLAINT CONTROL NUMBER: 56-AS-20240618110915
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: 160DATE:
06/19/2024
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Patrick McAdoo-Morton, Executive DirectorTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff are not assisting residents in a timely manner.
Staff are not ensuring residents are provided adequate food service.
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 Executive Director Patrick McAdoo-Morton and explained the elements of the complaint.

Regarding the allegation that staff are not assisting residents in a timely manner; LPA Prieto interviewed resident #1 (R1), in question, who states that communication with staff is done by pressing the facility call button, asking for assistance when the med tech staff arrive, asking services from direct care staff and even calling the front office directly from a cellular phone. R1 discussed an incident of a fall when the call button was pressed and assistance from staff arrived immediately.
***continued on LIC 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
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-20240618110915
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: 06/19/2024
NARRATIVE
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Regarding the allegation staff are not ensuring residents are provided adequate food service; Interview with staff #1 (S1) states the R1 does dine, with other residents, in the dinning area during meals times. Resident notes reveal the R1 has called to be escorted to the dining area for meals and notes when R1 has refused to be escorted for meals. R1 stated that meals that were refused were by her own accord. R1 added that the meals at the facility are excellent in quality and enjoys the company of facility peers.

Based on the information obtained there is not enough evidence that staff are not assisting residents in a timely manner and staff are not ensuring residents are provided adequate food service. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Executive Director McAdoo-Morton and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC9099 (FAS) - (06/04)
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