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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005740
Report Date: 11/19/2025
Date Signed: 11/19/2025 03:59:37 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/14/2025 and conducted by Evaluator Claudia Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20251114161246
FACILITY NAME:OAKMONT OF ORANGEFACILITY NUMBER:
306005740
ADMINISTRATOR:ANNA PASTORESFACILITY TYPE:
740
ADDRESS:630 THE CITY DRIVE SOUTHTELEPHONE:
(714) 880-8624
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY:155CENSUS: 101DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Anna PastoresTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Licensee is not ensuring that resident has the ability to make and receive confidential phone calls.
INVESTIGATION FINDINGS:
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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez. LPA met with Executive Director (ED) Anna Pastores and Health Services Director (HSD) Alyson Womack and discussed the purpose of the inspection.

Regarding the allegation, Licensee is not ensuring that resident has the ability to make and receive confidential phone calls, the following was revealed: It is alleged R1 does not have the ability to make and receive confidential phone calls. During the course of the investigation, interviews were conducted with R1, six additional facility residents, and two staff. During their interview, R1 stated they are able to make and receive and make private phone calls, however, was unable to indicate how the phone calls are made or received. During their interview, six of six additional facility residents stated they are able to make and receive private phone calls from their respective bedroom, using a landline or a personal cell phone. (Cont. LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
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 5
Control Number 22-AS-20251114161246
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 ORANGE
FACILITY NUMBER: 306005740
VISIT DATE: 11/19/2025
NARRATIVE
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During their interview, two of two staff denied the allegation and stated residents are able to make and receive private phone calls in their respective bedrooms using a land line or their own personal cell phone and stated a tablet is also available at the receptionist area and residents are able to use the tablet to make video calls at their own discretion and in the privacy of their own bedroom.

Due to allegation being uncorroborated during interviews conducted, the Department is unable to determine if Licensee is not ensuring that resident has the ability to make and receive confidential phone calls. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/14/2025 and conducted by Evaluator Claudia Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20251114161246

FACILITY NAME:OAKMONT OF ORANGEFACILITY NUMBER:
306005740
ADMINISTRATOR:ANNA PASTORESFACILITY TYPE:
740
ADDRESS:630 THE CITY DRIVE SOUTHTELEPHONE:
(714) 880-8624
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY:155CENSUS: 101DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Anna PastoresTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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9
Resident was admitted to the facility without the consent of their Power of Attorney.
INVESTIGATION FINDINGS:
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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez. LPA met with Executive Director (ED) Anna Pastores and Health Services Director (HSD) Alyson Womack and discussed the purpose of the inspection.

Regarding the allegation, Resident was admitted to the facility without the consent of their Power of Attorney (POA), the following was revealed: It is alleged R1 was admitted to the facility without the consent of their POA. During their interview, R1 denied being conserved or having a POA. Upon record review of R1’s facility file, Arizona Mental Health Care POA dated August 12, 2015 was observed, which states in part, “…The below listed individuals will serve in the order in which their names appear...”. The POA goes on to name two individuals in order in which they will serve. During the course of the investigation, the first individual named as POA, Witness 1 (W1) was interviewed and denied having any knowledge of R1 being admitted to the facility prior to or on R1’s admission date and stated they had not given consent for R1 to be admitted to the facility. (Cont. LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20251114161246
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 ORANGE
FACILITY NUMBER: 306005740
VISIT DATE: 11/19/2025
NARRATIVE
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LPA obtained a copy of R1’s Admission Agreement dated October 31, 2025 and observed it had not been signed by listed individuals in order in which they will serve and did not include named POA, W1’s signature.

Based on R1’s record review and witness interview, the preponderance of evidence standard has been met; therefore, the above allegations is found to be substantiated. Deficiencies are being cited per Title 22 Division 6 of the California Code of regulations. (See LIC9099-D). An exit interview was conducted and a copy of this report, and appeal rights were left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20251114161246
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 ORANGE
FACILITY NUMBER: 306005740
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/20/2025
Section Cited
CCR
87457(b)
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(b) No person shall be admitted without his/her consent and agreement, or that of his/her responsible person, if any.

This requirement is not met as evidenced by:
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AD stated an admission agreement will be entered with R1's POA and a signed and dated copy will be provided to LPA via email.
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Based on record review and witness intervew, the Licensee did not comply with the section cited above as R1's POA did not consent nor sign R1's admission agreement.
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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.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5