197610183-11-22-2022-31-AS-NGID-CUPU3S-20230814151355

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610183
Report Date: 11/22/2022
Date Signed: 11/22/2022 07:20:57 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
11/18/2022 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20221118155410

FACILITY NAME:	OAKMONT OF VALENCIA		FACILITY NUMBER:	197610183
ADMINISTRATOR:	CYNTIA DRACHENBERG		FACILITY TYPE:	740
ADDRESS:	24070 COPPER HILL DRIVE		TELEPHONE:	(661) 568-6080
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91354
CAPACITY:	144	CENSUS: 101	DATE:	11/22/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Julius Osorio, Regional Operations Specialist.		TIME COMPLETED:	07:00 PM

ALLEGATION(S):

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Facility does not have adequate staffing
Staff administered medications to residents without physician's orders
Resident sustained an injury from being over medicated

INVESTIGATION FINDINGS:

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At approximately, 9:00am Licensing Program Analysts (LPAs), Angela Panushkina and Michael Cava arrived to Oakmont of Valencia in response to the above mentioned allegations. LPAs met with the Regional Operations Specialist and explained the reason for the visit.

LPAs conducted a physical plant walk through, at approximately 10:30am, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. LPAs did not observe any immediate health and safety issues during the visit.

LPAs conducted interview with the Regional Operations Specialist, five (5) out of five (5) staff members, three (3) MedTechs, Chef, one (1) cook, ten (10) out of ten (10) residents and reviewed facility records from 12:00pm to 4:00pm. LPA also obtained copies of pertinent documents relevant to the investigation.

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: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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-20221118155410

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: 197610183
	VISIT DATE: 11/22/2022

NARRATIVE

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Allegation: Facility does not have adequate staffing

Interviews with five (5) out of ten (10) residents, who were able to communicate, three (3) out of five (5) staff members, three (3) out of three (3) MedTechs revealed that the facility has enough staff members during all three shifts to meet residents needs. Interview with the Regional Operations Specialist revealed that even though the facility has enough staff to cover all shifts, they are on ongoing process to hire extra people for back up purposes. Based on information obtained through interviews and document review this allegation is deemed Unsubstantiated.

Allegation: Staff administered medications to residents without physician's orders

Interviews with five (5) out of ten (10) residents, who were able to communicate, revealed that they never take medications without their doctor's prescription order. Interviews with three (3) out of three (3) MedTechs revealed that they would never give a medication to a resident without the Doctor's order. Interviews also revealed that when a change of order is prescribed the MedTech will not start a new medication until the new prescription order is received from the doctors office. LPAs reviewed three (3) out of three (3) random resident files and observed that doctor's orders of new or changed medications were attached. Based on information obtained through interviews and document review this allegation is deemed Unsubstantiated.

Allegation: Resident sustained an injury from being over medicated

In relation to allegation staff administered medications to residents without physician's orders, it was also reported that R1 sustained an injury from being over medicated. Interviews with five (5) out of five (5) staff and two (2) out of three (3) MedTechs do not corroborate with the allegation that R1 sustained injuries that they were over medicated. Therefore, Based on information obtained through interviews and document review this allegation is deemed Unsubstantiated.

Exit interview conducted and copy of report was provided to the Regional Operations Specialist.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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