195850209-6-13-2023-29-AS-DPEA-CUYSM7-20230823135929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850209
Report Date: 06/13/2023
Date Signed: 06/13/2023 04:06:44 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/12/2023 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20230612132851

FACILITY NAME:	OAKMONT OF AGOURA HILLS		FACILITY NUMBER:	195850209
ADMINISTRATOR:	SAHAR MOSALLA		FACILITY TYPE:	740
ADDRESS:	29353 CANWOOD STREET		TELEPHONE:	(747) 755-5700
CITY:	AGOURA HILLS	STATE: CA	ZIP CODE:	91301
CAPACITY:	102	CENSUS: 64	DATE:	06/13/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Aman Saund - Health Service Director		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Facility is without qualified staff to care for the residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit to investigate the allegation listed above. Upon arrival LPA met with Health Service Director Aman Saund and explained the reason for the visit.

At approximately 11:30am, LPA toured physical plant, interviewed staff, residents as well as reviewed and obtained copies of pertinent documentation relevant to the investigation.

It was reported that the facility is without qualified staff to care for the residents as it was alleged the facility does not have an Executive Director resulting in stress amongst the residents. Interviews conducted and records review revealed, Former Executive Director Sahar Mosalla's last day in the community was 05/19/2023.Since then, Regional Director of Operations, Kevin Booth has been acting as interim Executive Director. A new Executive Director is scheduled to be on board by 06/21/2023.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023

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 29-AS-20230612132851

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: OAKMONT OF AGOURA HILLS	FACILITY NUMBER: 195850209
	VISIT DATE: 06/13/2023

NARRATIVE

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Continued from 9099

Kevin, along with other multiple staff have provided administrative support for the facility and will continue to provide support until the new Executive Director is onboard. Interviews with (7) residents further revealed , all were notified about the former Executive Director leaving their position and each have not observed any drop off of service or care from staff. Based on information obtained there is insufficient evidence to support the allegation occurred. Therefore, the allegation of "facility is without qualified staff to care for the residents" has been deemed Unsubstantiated at this time.

Exit interview conducted and copy of report issued.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023

LIC9099 (FAS) - (06/04)

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