197610183-5-20-2024-31-AS-TAGD-D5NMEW-20240527093326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610183
Report Date: 04/30/2024
Date Signed: 05/20/2024 12:58:31 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
01/11/2024 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240111135934

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: 95	DATE:	04/30/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Myla Belson		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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1. Facility did not make sure residents have hot water
2. Residents’ incontinence needs are not being met
3. Residents’ bathing needs are not being met
4. Facility did not make sure elevator was in working condition

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tuesday Cabiness conducted today's subsequent visit to amend report that was originally created on 04/30/2024. The original document was missing pertinent verbiage that should have been documented on the report. LPA met with Executive Director Myla Belson and informed her the reason of the visit.

Allegation # 1: It was alleged facility did not make sure residents have hot water. On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. It was reported, the facility did have plumbing issues, and certain resident’s rooms water temperature was low. The Executive Director (ED) contacted the family, reported to Licensing, notified residents and their family. Facility used vacant rooms, to ensure residents had hot water and their personal hygiene needs were met.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

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-20240111135934

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: 04/30/2024

NARRATIVE

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Although the facility did not have hot water in various resident rooms, the ED contacted a plumbing company and the issue was resolved, and there were vacant rooms for residents to use for hot water use. Also, the entire facility was not impacted of not having hot water. Therefore, based on documentation and interviews, the allegation is Unsubstantiated. Allegation # 2: It was alleged residents’ incontinence needs were not met. On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. It was reported, the facility did have plumbing issues, and certain resident’s rooms water temperature was low. Although there were various resident’s rooms that had no hot water, the facility notified all the proper representatives and family and utilized vacant rooms for residents to use, therefore resident’s incontinent care needs was provided for. Based on documentation, the allegation is deemed Unsubstantiated at this time. Allegation #3: It was alleged residents’ bathing needs are not being met. On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. It was reported, the facility did have plumbing issues, and certain resident’s rooms water temperature was low. Although there were various resident’s rooms that had no hot water, the facility notified all the proper representatives and family and utilized vacant rooms for residents to use, so personal hygiene, such as showering, bathing and toileting were met. Therefore, based on documentation, the allegation is deemed Unsubstantiated at this time. Allegation # 4: It was alleged facility did not make sure elevator was working condition. On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. According to information obtained, during the visit with (LPAs) Tan and Cava, it was reported that to them by the ED Myla Belson, that one of the wires got caught which caused the elevator to stop operating. Staff were instructed to stay at the stairwell for the residents that needed assistance coming up or downstairs. Although it was reported facility did not ensure the elevator was working, the ED contacted an elevator company, and the issue was resolved within a couple of hours. Facility took proper safety measures for the residents, therefore at this time, the allegation is deemed Unsubstantiated.

Exit interview and copy of report provided.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024

LIC9099 (FAS) - (06/04)

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