197609904-10-22-2022-31-AS-EMIR-D3HUJR-20240319153759

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609904
Report Date: 10/22/2022
Date Signed: 10/22/2022 02:33:26 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
07/16/2021 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20210716084249

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: 102	DATE:	10/22/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rhonda Bunnin		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Multiple residents have fallen and sustained severe injuries while in care
Staff are mismangaing residents medication
Resident has scabies
Staff did not safeguard residents personal belongiongs
Staff are not feeding resident
Facility equipment to meet resident's needs is in disrepair
Staff are not meeting resident's hygiene needs
Facility is not properly disposing of medical waste

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Gary Tan and Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. LPAs met with the Memory Care (MC) director, Rhonda Bunnin, and advised her of the investigation. At approximately 9:00am to 11:00am, LPAs conducted a physical plant inspection. Between 11:00am to 2:00pm, interviews and record review was made.

Multiple residents have fallen and sustained severe injuries while in care:
In regards to the allegation, it was reported that mulitiple residents have fallen and sustained injuries due to lack of supervision. During the course of the investigation, LPA was not able to reach the reporting party (RP) to get more details regarding the allegation because RP did not provide any contact information including phone, physical and/or email address. RP did identify some residents, who may be the subject of the complaint and knowledge of the allegation. LPAs conducted a review of these residents on

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2022

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 4

Control Number 31-AS-20210716084249

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: 10/22/2022

NARRATIVE

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the facility's resident roster and identified that the residents do reside at the facility. LPAs then conducted a review of the Incident Reports submitted by the facility around the time the complaint was made, and confirmed that these residents experienced a fall, but the facility self-reported these falls, properly assessed each resident after their falls, and called for the immediate medical attention. Although it was confirmed that some residents experienced a fall while in care, there was insufficient evidence to prove the cause of the falls was due to lack of supervision, as there was supervision and immediate attention was provided to address the falls as indicated on the Incident Reports submitted by the facility. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are mismanaging resident medication:
In regards to the allegation, it was reported that Resident 1 (R1) wasn't given their medications as prescribed. LPAs conducted a review of R1's Medication Records (MAR), which revealed that R1 had a new order for Seroquel in June 2021. LPAs reviewed R1's MAR for the months of May to June 2021, and did not observe any discrepancies when R1 was administered their medication. Furthermore, there is no record of an overdose in July 2021, or hospitalization due to an overdose on July 2021. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff mismanaging R1's medication. Therefore, the allegation is deemed Unsubstantiated at this time.

Resident has scabies:
In regards to the allegations, it was reported that Resident 2 (R2) had scabies, and was not getting showers. This allegation was investigated previously by LPA Tan. During the course of LPA Tan's interview, it was revealed that R1 never had a confirmed scabies case. Staff did a body check on R2 and reported it to the hospice agency. The hospice did not want R2 to be brought to the hospital so there was no culture performed so there was no confirmed diagnosis. The facility just put R2 on isolation for the next two (2) weeks and the staff wore full PPE when attending to R2. Hospice agency monitored R2 during the isolation period. Review of R2's facility files also does not confirm that R2 was diagnosed or provided medication for scabies. Based on the information obtained, there was insufficient evidence to corroborate the allegation that R2 has scabies. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20210716084249

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: 10/22/2022

NARRATIVE

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Staff did not safeguard residents personal belongings:
During the course of the investigation, LPA was not able to reach the reporting party (RP) to get more details on the allegation because RP did not provide any contact including phone, physical and/or email address. RP also did not provide any identifier of any resident who may be the subject of the complaint nor any witness or staff who may have the knowledge of the allegation. LPAs did conduct interviews with ten of ten residents, and based on those interviews, there was insufficient evidence to corroborate the allegation of staff not safeguarding residents personal belongings. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not feeding resident:
In regards to the allegation, it was reported that Resident 3 (R3) is not being fed. LPAs were unable to interview R3 as they moved out of the facility February 21, 2020. LPAs did interview ten of ten residents, and based on those interviews, there was insufficient evidence to corroborate the allegation of staff not feeding them. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility equipment to meet resident's needs is in disrepair:
In regards to the allegation, it was reported that the facility had faulty walkie talkies, cell phones and pagers to answer resident call buttons. During the course of the investigation, LPAs ran a test of facility equipment while on a physical plant inspection, and observed them to be operable. Response time was within five minutes. Furthermore, LPAs were advised that the facility just purchased a brand new set of walkie talkies and pagers for each staff on September 30, 2022. Based on the information obtained, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not meeting resident's hygeine needs:
In regards to the allegation, it was reported that Resident 2 (R2) was not getting showers. LPAs were unable to interview R2 as R2 is no longer at the facility. LPAs did interview ten of ten residents and they had no complaints about not getting showers. Based on the information obtained, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20210716084249

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: 10/22/2022

NARRATIVE

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Facility is not properly disposing medical waste:
In regards to the allegation, it was reported that facility is storing waste disposal and medical waste in a large storage room, and/or in apartment room #147 and 148. This investigation was also addressed by LPA Tan on May 14, 2021 (see control #31-AS-20210505141954). LPA Tan interviewed with four (4) care staff, who revealed that it is part of their routine to pick up the trash in the residents' room and throw it in the big trash can inside the laundry room and then throw them out to the big trash bins at the end of every shift, where it is collected twice a week. LPA interview with the Maintenance Director and Resident Care Services Director confirmed that the trash were being disposed of properly from the residents' room to the waste bin outside of the facility. During the physical plant inspection, LPAs checked out the large storage room and apartment room #147 and 148 and did not observe waste disposal or medical waste being stored there. Therefore, based on the information obtained, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2022

LIC9099 (FAS) - (06/04)

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