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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608846
Report Date: 11/18/2021
Date Signed: 11/18/2021 12:55:34 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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/01/2021 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20211101084615
FACILITY NAME:OASIS SENIOR LIVINGFACILITY NUMBER:
197608846
ADMINISTRATOR:GRANT ABADZHYANFACILITY TYPE:
740
ADDRESS:7001 GARDEN GROVETELEPHONE:
(818) 697-5253
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
10:14 AM
MET WITH:Dinah PascoTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff grabbed residents in a rough manner
Staff force-fed resident
Staff did not seek timely medical attention for resident
Staff threatened resident
Staff forced resident to sign papers
Staff refusing resident communications
INVESTIGATION FINDINGS:
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On 11/18/2021 at 10:25 AM, Licensing Program Analyst (LPA) Nicholas Reed met with Administrator for an unannounced complaint investigation.
LPA disclosed the reason for the visit and reviewed allegations from complaint.

Staff grabbed residents in a rough manner

In regards to the allegation above, LPA interviewed R1, Reporting Party (RP), and Administrator. R1 stated staff slammed R1’s legs on bed and arms on table, causing bruises. Per interview with RP, RP did not see bruises on R1 at the hospital on 10/28/2021. LPA interview with Administrator explained an incident of grabbing R1 in order to prevent a fall.
Based on these interviews, it was determined that the facility was not violating client’s rights, and the health and safety of clients were not in immediate or potential danger. The above allegation is unsubstantiated. Copy of report to be emailed to administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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 6
Control Number 31-AS-20211101084615
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197608846
VISIT DATE: 11/18/2021
NARRATIVE
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Staff force-fed resident

In regards to the allegation above, LPA interviewed R1, R1’s Power of Attorney (DPOA), and Administrator. R1 stated Administrator, “wouldn’t let [R1] have meds until [R1] ate breakfast”, while Administrator believed R1’s medication Quetiapine Fumarate should be taken after consuming food. Though this procedure did not follow any expressed physician’s orders, it is not considered force feeding since R1 had the right to refuse food.

Based on these interviews and determinations, it was determined that the facility was not violating client’s rights, and the health and safety of clients were not in immediate or potential danger. The above allegation is unsubstantiated. Copy of report to be emailed to administrator.

Staff did not seek timely medical attention for resident



In regards to the allegation above, LPA interviewed R1, R1’s Power of Attorney (DPOA), R1’s Home health nurse (HH), and Administrator. LPA also reviewed R1’s Physician’s Report from 09/30/2021. R1’s Physician’s Report noted R1 experiences confusion occasionally. DPOA expressed concerns of R1 appearing dehydrated and frail on 10/28/2021. Administrator reported asking if R1 wanted to go to the hospital on 3 different occasions. R1 refused each time. According to R1, staff never offered to take R1 to the hospital, so R1 called DPOA. HH noted a decline in R1’s health in Oasis Senior Living, stating, “the transfer probably made her confused”

R1 also submitted a positive COVID test upon arrival to the hospital on 10/28/2021. R1 reported never taking a COVID test at Oasis Senior Living, yet HH and Administrator recall testing R1 for COVID around 10/19/2021. HH ordered cough medicine and a Z-pak for R1’s symptoms on 10/18/2021. Per Administrator interview, R1 also tested negative for COVID on 09/27/2021 prior to entering facility. Administrator stated R1 showed symptoms of runny nose and cough throughout the stay at Oasis Senior Living. Through offering hospital access and providing medication for illness, Oasis Senior Living provided adequate care and supervision of R1.

Based on interviews, record review, and determinations, it was determined that the facility was not violating client’s rights, and the health and safety of clients were not in immediate or potential danger. The above allegation is unsubstantiated. Copy of report to be emailed to administrator.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 31-AS-20211101084615
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197608846
VISIT DATE: 11/18/2021
NARRATIVE
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Staff threatened resident

In regards to the allegation above, LPA interviewed R1 and Administrator. Administrator often encourages and guides residents, but Administrator knows she cannot force residents to do anything. Administrator believes her message may have been misconstrued.

Based on interviews and observations, it was determined that the facility was not violating client’s rights, and the health and safety of clients were not in immediate or potential danger. The above allegation is unsubstantiated. Copy of report emailed to Administrator.

Staff forced resident to sign papers

In regards to the allegation above, LPA interviewed R1. R1 recalls willingly signing paperwork to enter hospice, though R1 was exhausted.

Based on this interview, it was determined the facility was not violating client’s rights and the health and safety of clients were not in immediate or potential danger. The above allegation is unsubstantiated. Copy of report emailed to Administrator.

Staff refusing resident communications

In regards to the above allegation, LPA interviewed Administrator and DPOA. DPOA noted difficulty reaching R1 over the phone. Administrator showed two phones available for all residents, one corded and one cordless. Administrator explained she also permits use of her personal phone for Facetime, though Administrator got busy occasionally and missed a few calls from DPOA to R1.

Based on this interview, it was determined the facility was not violating client’s rights. The health and safety of client was not in any danger. The above allegation is unsubstantiated. Copy of report emailed to Administrator.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/01/2021 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20211101084615

FACILITY NAME:OASIS SENIOR LIVINGFACILITY NUMBER:
197608846
ADMINISTRATOR:GRANT ABADZHYANFACILITY TYPE:
740
ADDRESS:7001 GARDEN GROVETELEPHONE:
(818) 697-5253
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
10:14 AM
MET WITH:Dinah PascoTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Facility put resident on hospice without responsible party's knowledge or permission
Staff did not assist resident with blood glucose monitoring
INVESTIGATION FINDINGS:
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On 11/18/2021 at 10:25 AM, Licensing Program Analyst (LPA) Nicholas Reed met with Administrator for an unannounced complaint investigation. LPA disclosed reason for visit and reviewed allegations from complaint.

Staff did not assist resident with blood glucose monitoring

In regards to the allegation above, LPA interviewed R1 and Administrator. R1 reported having Diabetes Type 2 since 1994. R1 reported being able to independently administer insulin and check blood glucose. Administrator noted she sometimes assisted squeezing R1’s finger for blood check when R1 experienced tremors. Administrator stated R1 kept records of all blood sugar checks, yet R1 reported maintaining no such record. Administrator could not produce a record of blood checks.
Based on interviews and observations, it was determined that the facility did not track resident blood glucose levels, which posed a potential health and safety risk to the resident in care. The above allegation is substantiated. Copy of report emailed to Administrator. Plan of Correction created.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 31-AS-20211101084615
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197608846
VISIT DATE: 11/18/2021
NARRATIVE
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Facility put resident on hospice without responsible party's knowledge or permission

In regards to the allegation above, LPA attempted a file review, though Administrator stated all hospice paperwork has been destroyed. LPA interviewed R1 and Administrator. R1 recalls signing hospice paperwork, but Administrator claimed no medical services were provided. Administrator assumed a verbal agreement between DPOA and licensee’s mother. Administrator noted it was “just an evaluation”. Administrator did not make an effort to inform R1’s power of attorney.

Based on this interview, it was determined the facility performed an evaluation without informing the resident’s representative. This posed a potential health and safety risk to the resident in care. The above allegation is substantiated. Copy of report emailed to Administrator. Plan of Correction created.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6
Control Number 31-AS-20211101084615
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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197608846
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/26/2021
Section Cited
CCR
87468.1(a)(8)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall ...
(8) have their representatives regularly informed by the licensee of activities related to care, including ongoing evaluations
This requirement is not met as evidenced by:
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Administrator and Licensee will review regulations, and will create a facility document for future evaluation verifications. Administrator will email this form to LPA by POC due date.
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Based on LPA interviews, it is determined Licensee and Administrator failed to inform R1’s power of attorney about R1’s hospice evaluation. This posed a potential health and safety risk to resident in care. Report emailed to Administrator and Plan of Correction created.
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Type B
11/26/2021
Section Cited
CCR
87464(f)(2)
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87464 Basic Services
(f) Basic services shall at a minimum include:
(2) Safe and healthful living accommodations and services

This requirement is not met as evidenced by:
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Administrator will create a log for all residents with diabetes to monitor blood sugar levels. Administrator will email a copy of the log to LPA by 11/26/2021
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Based on LPA interviews, it is determined Licensee failed to maintain a medical record for R1’s diabetes. This posed a potential health and safety risk to the resident in care. Exit interview conducted and report delivered. Administrator created Plan of Correction.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 6