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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609905
Report Date: 06/20/2022
Date Signed: 06/20/2022 10:46:27 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
07/21/2020 and conducted by Evaluator Patrick Shanahan
COMPLAINT CONTROL NUMBER: 31-AS-20200721103138
FACILITY NAME:OAKMONT OF SANTA CLARITAFACILITY NUMBER:
197609905
ADMINISTRATOR:GINA SALMANFACILITY TYPE:
740
ADDRESS:28650 NEWHALL RANCH ROADTELEPHONE:
(661) 295-2025
CITY:SANTA CLARITASTATE: CAZIP CODE:
91355
CAPACITY:0CENSUS: 93DATE:
06/20/2022
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Tom Park/ AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to issue refund
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in order to deliver findings for the above mentioned allegation. LPA was able to speak with facility administrator.

On 6/15/2022, LPA Avetisyan, arrived at the facility in order to deliver findings on the additional allegations of this complaint report. While at the facility the LPA was provided documentation that states on 7/24/20, a check was prepared by the facility accounting department for a refund to the resident in question (R1).
On 4/13/2021, LPA Shanahan, received an email from R1's power of attorney and confirmed that a refund had been issued in July of 2020. A copy of the invoice with the refund check number was provided to the LPA on todays visit.
Based on facility documentation and from confirmation from R1's power of attorney, this allegation is deemed to be Unsubstantiated at this time.

Exit interview conducted and report issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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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