197609905-9-24-2021-31-AS-NGID-C7QMZC-20211012100256

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609905
Report Date: 09/24/2021
Date Signed: 09/24/2021 02:43:22 PM

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
09/16/2021 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20210916105043

FACILITY NAME:	OAKMONT OF SANTA CLARITA		FACILITY NUMBER:	197609905
ADMINISTRATOR:	GINA SALMAN		FACILITY TYPE:	740
ADDRESS:	28650 NEWHALL RANCH ROAD		TELEPHONE:	(661) 295-2025
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91355
CAPACITY:	121	CENSUS: 91	DATE:	09/24/2021
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Thomas Park, Executive Directior		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Insufficient staffing to meet residents' needs
Residents are given insulin shots by staff members who are not medical professionals

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Panushkina and Licensing Program Manager (LPM) Nichelle Gillyard met with the Administrator Thomas Park at 9:40am for a complaint investigation.
Entrance interview conducted.
At 9:42am LPA/LPM requested LIC500 and room roster. LPA/LPM requested files at 10:15am, review conducted at 11:42am. File review consists but is not limited to review of the physician report, resident care plans, relevant logs, etc.
LPA/LPM conducted a tour and interviewed a sample of 10 residents from 10:45am to 1:30pm .
During tour LPA randomly tested a resident’s pendant.
LPA/LPM conducted sample interviews of 5 caregivers,1 Med Tech, Executive Director, Memory Care Director and Health Sevices Director
The complainants concern is that there is insufficient staff to meet the resident’s needs.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

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-20210916105043

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 SANTA CLARITA	FACILITY NUMBER: 197609905
	VISIT DATE: 09/24/2021

NARRATIVE

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After review of the information received the allegation, Insufficient staffing to meet the resident’s needs is unsubstantiated at this time. Interviews with 8 out of 10 residents, who are able to communicate, indicate that staff are meeting their needs within a timely manner and are happy with service.
LPA/LPM conducted a random inspection of the pendant at 11:01 am, staff responded within a reasonable time at 11:07 am. The facilities expectation for response time is 10 min.

Interviews with 3 out of 5 staff indicate that there is sufficient staffing to meet the needs of the resident’s timely due to their communication with each other. Two (2) out of 5 staff indicate that there is a staffing issue when someone calls in sick, however a manager will step in the position of caregiver to assist and help staff. Interview also indicated that the Med Tech will step to assist caregivers as needed.

Allegation: Residents are given insulin shots by staff members who are not medical professionals.

LPA/LPM identified 3 out of 91 residents receiving insulin injections in the facility. Two (2) out of 3 residents, who are available indicate that the facility nurse, and not the caregivers, is assisting with insulin injections.

Four out of 5 caregivers interviewed, indicate that injections are only given by the facility nurse. The med tech on duty confirmed that only the facility nurse it to assist with glucose injection testing and giving insulin injects no other staff is allowed. LPA interviewed Health Services Director, Hugo Lemus, at 1:34pm and was informed that residents were assisted "hand over hand", however, residents made the actual injection. LPA/LPM clarified statement to make sure the Regulation regarding injection was followed. Therefore, after review of the information received the allegation, Residents are given insulin shots by staff members who are not medical professionals is unsubstantiated at this time.

No deficiency issued.

Exit interview.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

LIC9099 (FAS) - (06/04)

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