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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530032
Report Date: 07/30/2025
Date Signed: 07/30/2025 04:33:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
04/23/2024 and conducted by Evaluator Renese Howell-Small
COMPLAINT CONTROL NUMBER: 56-AS-20240423152956
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: 143DATE:
07/30/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Executive Director, Marc PaciaTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Staff make resident stay in their bed for an extended period of time.
Staff forced resident to purchase insurance.
Staff do not ensure that resident is being provided with activities.
Staff are not ensuring that resident's care needs are being met
INVESTIGATION FINDINGS:
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On 07/30/2025 at 1:30PM Licensing Program Analyst (LPA) Renese Howell-Small conducted an unannounced visit to the facility in order to deliver findings for the above allegations. LPA discussed the purpose of the visit with Exectuive DIrector, Marc Pacia. The investigation consisted of interviews, record review and observation.

In regards to the allegation that staff make resident stay in their bed for an extended period of time:
LPA interviewed four (4) staff, a relative and a friend of Resident 1 (R1). Staff denied the allegation and stated that R1 would refuse care and or getting out of bed due to pain. Staff stated that they encourage but do not force a resident to accept care. LPA observed the documentation confirming R1's refusal of care/assistance. The relative of R1 stated that R1 could be challenging and refuse care. Based on interviews and record review, this allegation is UNSUBSTANTIATED.

In regards to the allegation that staff forced resident to purchase insurance:
Staff denied that they forced R1 to purchase insurance. R1 had insurance and was receiving hospice services. Purchasing insurance is not required to become a resident. Both the relative and friend of R1 denied that R1 was forced to purchase insurance. Based on interviews, the lack of information and details to support it, this allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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-20240423152956
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SAVANT OF JURUPA VALLEY
FACILITY NUMBER: 335530032
VISIT DATE: 07/30/2025
NARRATIVE
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In regards to the allegation that staff do not ensure that resident is being provided with activities:
Staff stated that a variety of activities are provided for the residents on a weekly basis. LPA observed residents listening to music, a resident was playing the piano, playing Bingo and live music during several visits to the facility. In addition, residents with limited mobility are provided with one-on-one activities in their room. Based on interviews and observation, this allegation is UNSUBSTANTIATED.

In regards to the allegation that staff are not ensuring that resident's care needs are being met:
Staff stated that based upon their assessment, R1 needed full assistance and they provided this care. R1 was also receiving hospice services. The facility stated that R1 would refuse care and provided documentation to LPA. Based on interviews and record review, this allegation is UNSUBSTANTIATED.

UNSUBSTANTIATED is defined as the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

An exit interview was conducted where this report LIC9099 and LIC9099C was discussed and a copy was provided to Executive Director, Marc Pacia.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Renese Howell-Small
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC9099 (FAS) - (06/04)
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