197610183-5-15-2025-31-AS-TAGD-DHPTSX-20250616145952

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610183
Report Date: 05/15/2025
Date Signed: 05/15/2025 01:41:27 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
06/18/2024 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240618151354

FACILITY NAME:	OAKMONT OF VALENCIA		FACILITY NUMBER:	197610183
ADMINISTRATOR:	MYLA BELSON		FACILITY TYPE:	740
ADDRESS:	24070 COPPER HILL DRIVE		TELEPHONE:	(661) 568-6080
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91354
CAPACITY:	144	CENSUS: 103	DATE:	05/15/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Myla Belson		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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1. Staff do not seek medical attention in a timely manner for resident in care
2. Resident sustained injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit, to deliver the final findings of the allegations mentioned above. LPA met with Executive Director Myla Belson and informed her the reason reason of the visit. The following information was determined:

Allegation #1: It was alleged staff do not seek medial attention in a timely manner for resident in care. To investigate the allegation, on June 24, 2024, and during today’s visit, at various times between 9:30 a.m. and 2:30 p.m., the Licensing Program Analyst (LPA) conducted interviews and reviewed relevant documents pertaining to the allegation. Based on the information obtained, Resident #1 (R1) was identified as a fall risk. R1 had a history of multiple falls prior to admission and continued to experience falls while in care at the facility. Documentation reviewed revealed that, on each occasion R1 fell, the facility followed proper procedures, including providing first aid, contacting medical professionals, calling 911, and sending R1 to the hospital when necessary. The facility also notified R1’s family following each incident. Additionally, the facility implemented several measures to reduce the risk of further falls. These included ordering appropriate medical equipment

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

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-20240618151354

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: 05/15/2025

NARRATIVE

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and modifying care practices. An overnight care companion, and frequent routine wellness checks were conducted during the day to monitor R1. Therefore, based on interviews and documentation reviewed, there is insufficient evidence to support the allegation. The allegation is determined to be Unsubstantiated at this time.

Allegation # 2: It was alleged resident sustained injuries while in care. To investigate the allegation, on June 24, 2024, and during today’s visit, (LPA) conducted interviews and reviewed relevant documentation pertaining to the allegation. Based on the information obtained, Resident #1 (R1) was assessed upon admission and was noted to have pre-existing bruising and wounds. R1 was also identified as a fall risk. According to interviews, R1’s family reported that R1 had a history of falls while living at home prior to admission. After being admitted to the facility, R1 continued to experience multiple falls, resulting in bruising and injuries. Facility staff provided first aid, notified R1’s family and primary care physician, and ensured R1 received medical attention from healthcare professionals. Documentation confirmed that staff recorded the incidents in internal charting notes and submitted Special Incident Reports (SIRs) to Community Care Licensing (CCL). Although it was reported that R1 sustained injuries while in care, the facility responded appropriately by providing timely treatment, notifying responsible parties, and seeking necessary medical evaluation. Therefore, based on the interviews and documentation reviewed, there is insufficient evidence to prove the allegation, and it is Unsubstantiated at this time.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

LIC9099 (FAS) - (06/04)

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