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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005740
Report Date: 12/05/2024
Date Signed: 12/05/2024 03:57:17 PM

Document Has Been Signed on 12/05/2024 03:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:OAKMONT OF ORANGEFACILITY NUMBER:
306005740
ADMINISTRATOR/
DIRECTOR:
ANNA PASTORESFACILITY TYPE:
740
ADDRESS:630 THE CITY DRIVE SOUTHTELEPHONE:
(714) 880-8624
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY: 155CENSUS: 92DATE:
12/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Anna PastoresTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with Business Office Director (BOD) Dianna Kuhn and explained the purpose of the inspection. Executive Director (ED) Anna Pastores arrived at approximately 9:00 a.m.

During the inspection, LPA, ED, and Health Services Director (HSD) Alyson Womack conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, dining rooms, activity rooms, and observed the following:

This is a three-story building with a parking garage on the basement floor, first floor is used primarily for memory care, and the second and third floor are designated for assisted living. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. There are two separate courtyards and both contain shaded sitting areas. LPA observed residents participating in leisure activities, including live music, and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 112.6 - 120.5 degrees Fahrenheit. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. At least two fire extinguishers were observed in every facility hallway with service tags dated March 29, 2024. Facility appliances, including gas stove, refrigerator, freezer, laundry washer and dryer were inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents. LPA reviewed nine resident files and six staff files. LPA interviewed six residents and four staff.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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