198603479-11-21-2023-28-AS-LHIS-CXYM4B-20231127081624

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603479
Report Date: 11/21/2023
Date Signed: 11/21/2023 03:33:00 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/13/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231113141817

FACILITY NAME:	OAKMONT OF WHITTIER		FACILITY NUMBER:	198603479
ADMINISTRATOR:	JAKINI, ROBERT		FACILITY TYPE:	740
ADDRESS:	13617 WHITTIER BLVD.		TELEPHONE:	(562) 693-8222
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90605
CAPACITY:	97	CENSUS: 70	DATE:	11/21/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Janette Hill		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Facility staff did not dispense medications to resident as prescribed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted a visit in response to the above allegation. On today's visit, LPA met with Administrator, Janette Hill, who assisted with the visit.

Regarding the allegation that facility staff did not dispense medications to resident #1 as prescribed, the investigation consisted of review of of resident #1 medication list, hospital discharge documents, special incident report dated 11/17/23, and interviews with Administrator, and Health Services Director, Leslie Lopez.

The investigation revealed the following: Resident #1 was hospitalized during the period of March 2023 through August 2023. Resident #1 returned to the facility on 8/10/23, and transferred to the Memory Care Unit. It was recently brought to the facility's attention that resident #1's medication list was changed upon discharge from the hospital, but it was not updated upon resident #1's return to the facility.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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 28-AS-20231113141817

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF WHITTIER	FACILITY NUMBER: 198603479
	VISIT DATE: 11/21/2023

NARRATIVE

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Administrator, and Health Services Director stated that the facility has discontinued the medication(s) that should no longer be administered to resident #1, and has made corrections to medication list that had not been made upon resident #1's return to the facility. The facility also sent a special incident report to Community Care Licensing as required.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code.

An exit interview was conducted with Ms. Hill. A copy of the report and appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20231113141817

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: OAKMONT OF WHITTIER	FACILITY NUMBER: 198603479
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/21/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/21/2023 Section Cited CCR 87465(c)(2)	1 2 3 4 5 6 7	(c) If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: (2) Once ordered by the physician the medication is given according to the physician's directions.	1 2 3 4 5 6 7	Administrator stated that the facility has obtained d/c orders from resident #1's physician, and has stopped giving resident #1 the medications that were discontinued. Administrator and Health Services Director stated that a medication error and prevention training will be conducted, as well as a 3 way audit will be performed by the facility pharmacy, Pharmerica.
	8 9 10 11 12 13 14	This requirement was not being met as evidenced by: Resident #1 was still being administered the following medications : Losartan Potassium 25 mg tab, Melatonin 3 mg tab, it should have been d/c upon discharge from hospital in August 2023. This poses a health and safety risk to residents in care.	8 9 10 11 12 13 14
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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: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC9099 (FAS) - (06/04)

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