197609904-8-21-2022-31-AS-NMAN-CNMQPL-20230201112051

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609904
Report Date: 08/21/2022
Date Signed: 08/21/2022 02:52:50 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
07/28/2021 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20210728163608

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: 94	DATE:	08/21/2022
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Maria Roleda - Health Services Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility in disrepair

Facility has vermin

Facility not following policies of facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegations. LPA met with Health Services Director Maria Roleda and explained the reason for the visit.

LPA conducted physical plant tour at around 10:00 AM, requested facility documents relevant to the investigation at 10:30 AM and interviewed residents and staff between 10:30 AM to 1:00 PM.

Regarding the allegation that the facility is in disrepair, it was alleged that the facility had no hot water for six (6) weeks. LPA's record review today at 9:00 AM, revealed that this issue had been addressed and resolved on prior complaint (complaint control no.: 31-AS-20210505141954) dated 05/05/21, please see report dated 05/14/21. LPA's interview with the Maintenance Director on 08/04/21 at 11:00 revealed that the water heater had never been broken since it was repaired on 04/23/21. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2022

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-20210728163608

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: 08/21/2022

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that the facility has vermin, it was alleged that the facility had ants. LPA's record review at around 9:00 AM, revealed that the facility had contracted a pest control company visiting twice a month to avoid infestation at the facility. LPA interview with the Executive Director and Maintenance Director on 08/04/21 at around 11:00 AM revealed that they did not receive any report of ants infestation on any resident's room and would have addressed the situation immediately had they received the report.

Regarding the allegation that the facility is not following their own company policy, it was alleged that a resident has a 50 to 60 pound dog when the policy states that pets are not allowed over 30 pounds. LPA's record review at around 10:00 AM today, revealed that the dog is an emotional support dog and has full documentation on file (i.e., vaccination and doctor's certificate). LPA's interview with staff on 08/04/21 at 12:39 PM also revealed that the staff walk the dog everyday, never bothered anyone and does not leave the room of the resident without a leash.

Based on the information gathered during this and prior visit, there is insufficient information to support the allegations and therefore deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2022

LIC9099 (FAS) - (06/04)

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