197609904-10-29-2021-31-AS-EMIR-CE6MQB-20220506094829

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609904
Report Date: 10/28/2021
Date Signed: 10/29/2021 11:05:10 AM

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
04/15/2020 and conducted by Evaluator Angelica Arambulo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20200415115047

FACILITY NAME:	OAKMONT OF VALENCIA		FACILITY NUMBER:	197609904
ADMINISTRATOR:	VEIS, MARGIE		FACILITY TYPE:	740
ADDRESS:	24070 COPPER HILL DRIVE		TELEPHONE:	(661) 568-6080
CITY:	VALENICA	STATE: CA	ZIP CODE:	91354
CAPACITY:	0	CENSUS: 104	DATE:	10/28/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Patrice O GRady, Stephanie Funderberg		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Residents were left in their urine for a long period of time.
Resident is not being repositioned per physician's orders.
Resident is showing signs of skin breakdown.
Staff are not meeting the needs of the residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Arambulo conducted a subsequent visit to facility to deliver the above findings. LPA met with Memory Care Director Patrice O Grady. A copy of register of residents requested.

It is alleged that a resident was left in their urine for a long period of time. LPA conducted a review of resident file for the rooms given by the reporting party and there was no resident occupying the room number. LPA conducted interviews with caregiver’s who stated that the schedule of duties once they arrive is to change the resident’s diapers and check on them for the next diaper change. This has been the corroborated with staff and manager. The complainant could not provide the name of the individual or how long since the last diaper change. With the lack of information provided there is insufficient information to substantiate this allegation. The findings are Unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Angelica Arambulo	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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 31-AS-20200415115047

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: OAKMONT OF VALENCIA	FACILITY NUMBER: 197609904
	VISIT DATE: 10/28/2021

NARRATIVE

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It is alleged that a resident is not being repositioned per physician's orders. LPA conducted a file review for resident and there was no indication that resident needed to be repositioned. Resident is non- ambulatory but can reposition on their own and uses an electronic wheel chair. Based on the information gathered the allegation is unsubstantiated.

It is alleged that resident is showing signs of skin breakdown. This allegation is regarding a resident in room 102. As per the facility there was no one in room 102 when investigation started, LPA reviewed past history of occupancy and reviewed the resident file. LPA conducted a file review and observed no indication that the resident had issues with any skin breakdown. It was also observed that resident did not require any assist on toileting.

Based on the information gathered the there is insufficient information to substantiate this allegation. The conclusion is Unsubstantiated.

It is alleged that staff are not meeting the needs of the residents. The complainant had observed a resident complaining of pain and no medication was given. There is no name given by the complainant. Due to the lack of information given this allegation cannot be substantiated. Findings are Unsubstantiated at this time.

No citations issued. Exit interview conducted. Report shall be emailed to facility email.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Angelica Arambulo	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC9099 (FAS) - (06/04)

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