198320250-5-19-2023-11-AS-RORN-CTFPVR-20230705113935

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320250
Report Date: 05/19/2023
Date Signed: 05/19/2023 02:37:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 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
01/10/2023 and conducted by Evaluator Jeremiah Randle

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230110101021

FACILITY NAME:	OAKMONT OF TORRANCE		FACILITY NUMBER:	198320250
ADMINISTRATOR:	BELSON, MYLA		FACILITY TYPE:	740
ADDRESS:	3620 LOMITA BLVD		TELEPHONE:	(424) 376-3300
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90905
CAPACITY:	126	CENSUS: 96	DATE:	05/19/2023
		UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Anita Csukardi Executive Director		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Allegation: Staff did not answer resident's call button in a timely manner.

INVESTIGATION FINDINGS:

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Allegation:

Staff did not answer resident's call button in a timely manner.

On 5/19/2023 Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced subsequent complaint visit at the facility listed above. LPA arrived at facility and was greeted by Anita Csukardi Executive Director. LPA explained the purposed of the visit is to deliver findings on the allegations listed above.

Continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: 323-213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023

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 4

Control Number 11-AS-20230110101021

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF TORRANCE	FACILITY NUMBER: 198320250
	VISIT DATE: 05/19/2023

NARRATIVE

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The investigation consisted of the following:

LPA observed facility, as well as common areas of the facility. A comfortable temperature is maintained throughout the facility. LPA observed the facility to be operational and in good repair, LPA reviewed pertinent documents pertaining to the investigation. The following documents were gathered: Staff and Client Rosters, file for resident (R1) and any other pertinent documentation needs and service, physician report, residency agreement, medication records for R1. On 01/17/2023 LPA Randle interviewed (S1) and resident (R1). LPA requested, received, and reviewed the following information: file of R1, Staff roster, Resident roster, and other documents relevant to the investigation. On May 18, 2023, LPA interviewed Anita Csukardi Executive Director and Resident (R1) was follow up interviewed, LPA requested and reviewed pertinent documents pertaining to the investigation. LPA received the following pertinent documents pertaining to the investigation: Resident Roster, Staff Roster, Admissions Agreement, Needs and Services Plan, LPA reviewed Staff schedule, resident generated CALL ALERT signal times LPA interviewed staff (S2-S7) and residents (R1-R7). regarding allegation listed above. -Continued

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: 323-213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4

Control Number 11-AS-20230110101021

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF TORRANCE	FACILITY NUMBER: 198320250
	VISIT DATE: 05/19/2023

NARRATIVE

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The investigation revealed the following:

S1 stated that resident R1 did indeed activate R1’s call device for assistance for rest room care and staff did respond to the call for assistance. S1 stated to LPA that S1 investigated the incident and found R1 refused assistance from S4 due to gender differences. LPA interviewed staff S4 and S4 confirmed that S4 attempted to assist however R1 declined stating gender preference. S1 stated to LPA during this time period requested gendered preference staff was engaged with other residents that were requiring assistance at the same time. LPA reviewed call logs and found that multiple calls had occurred at or around the same time. R1 was however provided assistance by requested gender preference staff. LPA interviewed R1, R1 confirmed that she received assistance from S3 to the rest room and R1 stated R1 did not soil or wet R1’s person, however R1 stated “I wish help came quicker but I know they are always busy”. LPA interviewed staff S3, S3 confirmed S3 provided assistance to R1, S3 informed LPA “I do assist residents when we get busy all staff are trained to help out and respond asap”.

Continued

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: 323-213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20230110101021

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF TORRANCE	FACILITY NUMBER: 198320250
	VISIT DATE: 05/19/2023

NARRATIVE

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LPA interviewed Director of Care Services, S2, S2 denied the allegation. S2 stated to LPA all the staff responds timely to every call for assistance from all the residents. LPA interviewed staff (S2-S7) and staff confirmed they respond quickly to the call alerts from residents promptly as trained. LPA interviewed residents (R2-R7). regarding allegations listed above -Staff did not answer resident's call button in a timely manner, of residents interviewed the residents reported they had not encountered a problem with staff not responding timely.

Findings

Based on information gathered, the department did not find sufficient evidence to support the allegation. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegation is Unsubstantiated.

An exit interview was conducted and a copy of the LIC 9099 was provided to Anita Csukardi Executive Director

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: 323-213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023

LIC9099 (FAS) - (06/04)

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