198603136-6-24-2026-31-AS-MGFS-DVUV4M-20260710160634

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 05/20/2026
Date Signed: 06/24/2026 07:53:03 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/13/2026 and conducted by Evaluator Leslie Ngo-Castaneda

COMPLAINT CONTROL NUMBER: 31-AS-20260413155335

FACILITY NAME:	SAVANT OF BURBANK EAST		FACILITY NUMBER:	198603136
ADMINISTRATOR:	VILLANUEVA,IMELDA		FACILITY TYPE:	740
ADDRESS:	1900 GRISMER AVE		TELEPHONE:	(818) 843-3141
CITY:	BURBANK	STATE: CA	ZIP CODE:	91504
CAPACITY:	100	CENSUS: 91	DATE:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Marili Barajas- Business Office Manager		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff inappropriately sent resident to the hospital.
Staff did not ensure resident had colostomy bags.
Staff are not meeting residents needs.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced subsequent visit for the above allegation. LPA met with business office manager, Marili Barajas (S2) and explained the reason for the visit.

On 4/23/2026, LPA Ngo-Castaneda conducted a records review of the resident's file and other relevant documents, including the physician's report, admission agreement, medical records, LIC 500 (staff roster), resident roster, and other pertinent documents. On 5/20/2026, LPA toured the physical plant at 9:40 AM. At 10:04 AM, LPA interviewed the administrator and facility staff. At 10:18 AM, LPA interviewed a total of twelve (12) residents.

Allegation: Staff inappropriately sent resident to the hospital.

Continue to LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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 3

Control Number 31-AS-20260413155335

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF BURBANK EAST	FACILITY NUMBER: 198603136
	VISIT DATE: 05/20/2026

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

It was alleged that staff inappropriately sent the residents to the hospital. Interview conducted on 4/23/2026 at 12:00PM with facility administrator, revealed that resident #1 (R1) was brought to the hospital on 4/12/2026 at 4:10 PM to due to colostomy bags leak. Resident #2 (R2) was brought to the hospital on 4/12/2026 at 10:15 AM due to observation of maggots in R2’s stool and was discharged without conducting a stool check or laboratory exams.

Incident report revealed R1 was sent to the hospital due to colostomy bag was leaking and abdominal pain. Medical record review revealed R1 was discharge immediately and returned to the facility for colostomy care and gastritis. For R2, medical record revealed on 4/13/2026 at 8:25 AM, R2 was sent to the hospital again for abdominal pain and for laboratory exams. Medical records review revealed that R2 labs were eventually tested after the second visit on 4/13/2026. Interview with facility residents revealed that they are sent to the hospital when requested and necessary. Interview with staff revealed that residents are assessed first for their concerns and will be sent to the hospital when needed/ necessary.

Based on interviews and record review, there is insufficient information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff did not ensure resident had colostomy bags.

It was alleged that facility staff did not ensure that resident #1 (R1) had supplies of a colostomy bag in the facility. Interview with residents revealed that the facility supplies all the residents' needs in the facility including colostomy bags for them and never runs out. Interview with administrator revealed no other residents in the facility uses colostomy bag. Record review and invoices revealed that the facility purchases R1’s colostomy bags every two (2) weeks on auto-ship each order includes 20 pieces. Interview with residents revealed that they have no issues with the facility supplying their needs. Interview staff revealed that if residents need supplies, a request is sent to the administrator, and the administrator provides the supplies for the residents.

Based on interviews, observation, and record review, there is insufficient information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Continue to LIC 9099-C

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20260413155335

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAVANT OF BURBANK EAST	FACILITY NUMBER: 198603136
	VISIT DATE: 05/20/2026

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: Staff are not meeting residents needs.

It is alleged that facility staff are not meeting residents' needs. R1 colostomy bag was leaking. Interview with S1 revealed that they always meet residents' needs, but facility staff are not trained to change R1 colostomy bag. An interview with the facility administrator revealed that R1 has a physician order that R1 should change their own colostomy bag. Staff revealed that R1 changes their own colostomy bag, and they're not trained. Interview with R1 revealed that they changed their own colostomy bag, and the staff do not get involved. Interview with residents revealed they are getting all the supplies they need, and facility never run out of supplies. Residents expressed no concerns and informed LPA that staff are providing them with all their needs. During the physical plant tour conducted on 4/23/2026 and 5/20/2026, LPA observed adequate supplies in the facility. LPA also observed that staff respond to residents' requests for supplies and meet their needs promptly.

Therefore, based on interviews and LPA observation, interview, and record review, this allegation is deemed unsubstantiated at this time.

No deficiency cited during this visit.

Exit interview conducted, and a copy of this report signed and delivered.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3