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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 01/15/2025
Date Signed: 01/15/2025 04:22:12 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
01/06/2025 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250106142511
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:
01/15/2025
UNANNOUNCEDTIME BEGAN:
02:51 PM
MET WITH:Marc Pacia, Executive Director TIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not keep facility clean.
Staff does not keep facility free from odor.
Staff does not maintain residents hygiene
Staff does not feed residents.
Staff not putting meals in reaching distance for residents.
Staff not responding to resident's call button
Staff not assisting residents when requested
Staff leave resident in soiled diapers
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Executive Director Pacia and explained the elements of the complaint.

Allegation #1 and #2, staff does not keep facility clean and staff does not keep facility free from odor, LPA Prieto toured facility with Executive Director Pacia and found that the common areas, dining areas, lobby and facility corridors were clean, free from obstructions, and odors.

Allegations #3, staff does not maintain residents hygiene, LPA Prieto interviewed residents #1 (R1), R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, all state that staff assist with their hygiene needs as required by their needs and services plan. Those residents who are independent state the facility provides amenities to satisfy their hygiene needs.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
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 56-AS-20250106142511
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: 01/15/2025
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
Allegation #4 and #5, staff does not feed residents and staff not putting meals in reaching distance for residents. , LPA Prieto interviewed residents #1 thru #10 and R12, all stated that the facility provides three (3) meals a day where they can ambulate to the dinning area to eat. Those residents can ambulate freely or with the assistance of a walking aid, such as a walker or wheelchair. R11 states that tray service is provided and food is place within reaching distance to that resident could easily eat their food.

Allegation #6, staff not responding to resident's call button, LPA Prieto interviewed residents #1 (R1), R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, all who stated that staff respond when their call buttons are pressed.

Allegation #7, staff not assisting residents when requested, LPA Prieto interviewed residents #1 (R1), R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, all who stated that staff are attentive to their needs and request. Resident also stated that the request range from assistance with their hygiene needs to request to fixing appliances in their rooms.

Allegation #8, staff leave resident in soiled diapers, LPA Prieto interviewed residents #1 (R1), R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, all who state that if their needs and care plan requires them to be changed, staff will perform that duties during their shift. Residents have also stated that their call button is use for changing if necessary.

Based on the information obtained there is not enough evidence that . Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Executive Director Pacia and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2