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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320078
Report Date: 05/21/2021
Date Signed: 05/21/2021 04:44:04 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/11/2021 and conducted by Evaluator Don Senaha
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20210511115814
FACILITY NAME:OAKMONT OF TORRANCEFACILITY NUMBER:
198320078
ADMINISTRATOR:LEMON, ERIKAFACILITY TYPE:
740
ADDRESS:3620 LOMITA BLVDTELEPHONE:
(424) 338-4457
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY:126CENSUS: 75DATE:
05/21/2021
UNANNOUNCEDTIME BEGAN:
09:21 AM
MET WITH:Dollie BedollaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility does not have hot water.
INVESTIGATION FINDINGS:
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On 05/21/2021 Licensing Program Analyst (LPA) Don Senaha initiated a complaint investigation for the allegation listed above. LPA met with Health Services Director Dollie Bedolla and explained the purpose of the visit.

The investigation consisted of the following: Interviews conducted with Stacie Sheridan/Executive Director, residents (R1-R4) and plumbing service representative (W1). LPA obtained resident roster and staff roster. LPA requested copy of plumbing service summary of the services completed related to the allegation. A plant inspection of the facility was conducted.

Allegation: Facility does not have hot water.

LPA conducted interview with Stacie Sheridan/Executive Director. Executive Director Sheridan stated the hot water has been an ongoing issue since the building opened in September 2020. Executive Director
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Don SenahaTELEPHONE: (323) 629-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
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 11-AS-20210511115814
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: OAKMONT OF TORRANCE
FACILITY NUMBER: 198320078
VISIT DATE: 05/21/2021
NARRATIVE
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Sheridan stated a water pump was replaced a month ago as it was malfunctioning and it seemed to correct the water temperature issue at that time; however, a reoccurrence of the issue began again approximately one week ago. On 5/21/21, LPA conducted interview with (W1) who stated he is in the process of working on correcting the hot temperature issue.

LPA conducted testing of the water temperature. Rooms (104, 217, 220, 221) hot water temperature range was between 68.1 degrees F to 76.5 degrees F. Rooms (103, 229, 234, 239, 240) hot water temperature range was between 105.4 degrees F to 116.6 degrees F. Common restroom on first floor hot water temperature measured 119.7 degrees F. Common restroom on second floor hot water temperature measured 118 degrees F.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

No other deficiencies were cited.

An exit interview was conducted with Dollie Bedolla, and a hard copy was provided for signature.

SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Don SenahaTELEPHONE: (323) 629-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20210511115814
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF TORRANCE
FACILITY NUMBER: 198320078
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
05/24/2021
Section Cited
CCR
87303(e)(2)
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87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: Faucets...grooming shall deliver hot water. Hot water…temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by
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Administrator states the plumbing service to correct the hot water temparture was completed on 5/21/21. Administrator will provide fax copy of written confirmation of correction to CCLD by 5/24/21
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Based on observation and interviews, the licensee did not ensure to attain a water temperature of not less than 105 degree F and not more than 120 degree F, which poses an immediate health and safety risk to persons in care.

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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: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Don SenahaTELEPHONE: (323) 629-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3