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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610183
Report Date: 03/10/2025
Date Signed: 03/10/2025 01:22:46 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
04/22/2024 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20240422110306
FACILITY NAME:OAKMONT OF VALENCIAFACILITY NUMBER:
197610183
ADMINISTRATOR:MYLA BELSONFACILITY TYPE:
740
ADDRESS:24070 COPPER HILL DRIVETELEPHONE:
(661) 568-6080
CITY:VALENCIASTATE: CAZIP CODE:
91354
CAPACITY:144CENSUS: 100DATE:
03/10/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Myla BelsonTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not notice residents change in condition
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit, to complete the investigation and deliver the finding for the allegation mentioned above. LPA met with Executive Director Myla Belson and informed her the reason of the visit. The following was determined:

To investigate the allegation, on 04/30/2024 and during today’s visit from 9:30 AM to 1:30 PM, the LPA conducted interviews and reviewed facility and resident documents. It was alleged that staff did not notice a resident’s change in condition, and as a result, Resident 1 (R1) developed a urinary tract infection (UTI), which staff failed to detect. Based on the documentation reviewed, R1 was admitted to the facility, and within a few days, R1 was sent to urgent care due to blood in the urine. R1 was diagnosed with a UTI and received treatment. It was reported that R1’s responsible parties were involved and made aware of R1’s medical issues. Throughout R1’s stay, documentation indicated that R1 experienced multiple UTIs and other medical issues. The primary physician and family were involved, and R1 received appropriate treatment. Although it was reported that R1 had a UTI that facility staff was unaware of, the LPA determined that the facility documented
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
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 2
Control Number 31-AS-20240422110306
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF VALENCIA
FACILITY NUMBER: 197610183
VISIT DATE: 03/10/2025
NARRATIVE
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R1’s condition daily and maintained constant communication with the family and primary care physician. Therefore, based on interviews and documentation, the allegation is Unsubstantiated at this time.

Exit interview and copy of report provided.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2