197610184-7-25-2024-31-AS-NMAN-D7YRR8-20240809131443

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610184
Report Date: 07/25/2024
Date Signed: 07/25/2024 02:56:24 PM

Substantiated

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
03/19/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20240319143437

FACILITY NAME:	OAKMONT OF SANTA CLARITA		FACILITY NUMBER:	197610184
ADMINISTRATOR:	PARK, TOM		FACILITY TYPE:	740
ADDRESS:	28650 NEWHALL RANCH ROAD		TELEPHONE:	(661) 295-2025
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91355
CAPACITY:	121	CENSUS: 97	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Tom Park, Executive Director		TIME COMPLETED:	03:05 PM

ALLEGATION(S):

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Staff did not ensure the facility hot water was not in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegation. LPA met with Tom Park and explained the reason for the visit.

---Staff did not ensure the facility hot water was not in disrepair

It was alleged that the facility has intermittent hot water since 02/27/2024 and that residents are complaining about not being able to take hot showers. To investigate the allegation, on 03/21/2024 LPA conducted physical plant tour at around 11:00 AM, requested pertinent documents at 12:00 PM and interviewed staff between 12:30 PM to 02:30 PM. During the physical plant tour, LPA observed a hot water temperature of 111.4°F. A review of the facility’s Work Order records shows that 02/27/2024 a work order was initiated for no hot water in rooms #245, #244 and #239.
(CONT. on LIC 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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 3

Control Number 31-AS-20240319143437

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 SANTA CLARITA	FACILITY NUMBER: 197610184
	VISIT DATE: 07/25/2024

NARRATIVE

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During interviews with staff, Staff #3 stated there were issues with some of the wiring and parts but that a third-party company was immediately contact to resolve the issue. All other staff stated they did not experience any hot water issues and were only made aware of the issue when they witnessed other agencies in the facility to address the problem.

Based on interviews and record review, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

No other health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20240319143437

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 SANTA CLARITA	FACILITY NUMBER: 197610184
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/25/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/25/2024 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by;	1 2 3 4 5 6 7	A plan of correction was not issued as the facility took the necessary measures to have the hot water repaired and LPA observed hot water temperature at 111.4°F.
	8 9 10 11 12 13 14	Based on interviews and record review, hot water was not available in the facility for a given time which poses a potential health, safety and personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

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