335530032-2-26-2025-56-AS-KCLS-DEB8VX-20250227215148

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 02/26/2025
Date Signed: 02/26/2025 01:08:56 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
02/25/2025 and conducted by Evaluator Javier Prieto

COMPLAINT CONTROL NUMBER: 56-AS-20250225084849

FACILITY NAME:	SAVANT OF JURUPA VALLEY		FACILITY NUMBER:	335530032
ADMINISTRATOR:	PATRICK L. MCADOO-MORTON		FACILITY TYPE:	740
ADDRESS:	5881 EL PALOMINO DRIVE		TELEPHONE:	(951) 683-3333
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92509
CAPACITY:	197	CENSUS: 154	DATE:	02/26/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Marc Pacia, Executive Director		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff are not bathing resident
Staff are not providing food to the resident
Staff are not responding to residents calls for assistance
Staff are not taking resident to the dining room

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 Marc Pacia and explained elements of the complaint.

Allegation #1 - LPA Prieto interviewed resident #1 (R1) who states that he has been residing at the facility since 02/14/2025 and has been bathed twice since. LPA obtained R1's Resident Care Summary, from facility Wellness Director (S1), that states R1 has a 1 person assist with bathing 1 time per week. R1 was made aware of the bathing schedule and encouraged to press the call button for any additional services relating to bathing.

Allegation #2 - LPA Prieto interviewed resident #1 (R1) who states food is being provided to him by either having tray service to his room or escorts to meals in the dining area. Resident Care Summary for R1 indicates he needs full assistance with mobility that includes escorts to meal. S1 provided visual evidence of tray service to R1's room when he was not able to be escorted to the dining area.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20250225084849

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: 02/26/2025

NARRATIVE

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Allegation #3 - Interview with R1 stated that he does have a call pendent and when service is needed, he does press his call button and staff responds promptly. Interview with Executive Director (S2) stated that R1 was reminded that, if service is needed, staff will respond to the call button. R1 confirmed this statement and showed LPA that he does have a call button.

Allegation #4 - As indicated in allegation #3, R1 states food is being provide to him by either having tray service to his room or escorts to meals in the dining area. Resident Care Summary for R1 indicates he needs full assistance with mobility that includes escorts to meal. S1 provided proof that R1 was given a tray service meal while in his room when he was unable to be escorted to the dining area.

Based on the information obtained there is not enough evidence that staff are not bathing resident, staff are not providing food to the resident, staff are not responding to residents calls for assistance and staff are not taking resident to the dining room. 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: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

LIC9099 (FAS) - (06/04)

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