306005740-2-1-2023-22-AS-SSAS-CNUPQH-20230208103110

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005740
Report Date: 02/01/2023
Date Signed: 02/01/2023 02:27:21 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
03/12/2021 and conducted by Evaluator Michelle Reed

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210312144538

FACILITY NAME:	OAKMONT OF ORANGE		FACILITY NUMBER:	306005740
ADMINISTRATOR:	ROBERT JAKINI		FACILITY TYPE:	740
ADDRESS:	630 THE CITY DRIVE SOUTH		TELEPHONE:	(714) 880-8624
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY:	155	CENSUS: 98	DATE:	02/01/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Executive Director Anna Pastores		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility raised resident's rates without proper notice
Facility charged resident for services not rendered

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst Michelle Reed arrived at the facility to deliver the findings of this complaint investigation. Upon arrival, LPA met with Executive Director Anna Pastores. The investigation consisted of interviews with Executive Director Rosalie Sullivan, staff, and witnesses as well as documentation from the facility. The following was determined:

Resident #1 was admitted into the facility on 5/1/2018. R1 needed assistance with all Activities of Daily Living. R1 was a two person physical assist with transfers and pushing in a wheelchair to attend meals and activities. On November 1, 2020 according to Ms. Sullivan, a notice of rate increase for assisted living residents was sent to R1's responsible party. The increase was to take effect on January 1, 2021. In February of 2021, R1's responsible party denied receiving notice of the increase and disputed the costs that R1 had been billed for. Facility staff worked with R1's responsible party and sent another notice of the increase on March 5, 2021 to take effect on May 5, 2021. Facility staff also credited fees for January, February and March of 2021 for the cost of care difference that was disputed by the responsible party once it was brought to their attention.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle Reed	TELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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 2

Control Number 22-AS-20210312144538

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: 02/01/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility did not refund for escort services needed by R1. R1 also had automatic payment to the facility so responsible party had not reviewed the bill for any over charges. R1 moved from the facility on 12/11/21.

Based upon interviews conducted, the allegations are unsubstantiated, meaning that that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Licensee is reminded that resident bills should be audited to ensure that residents are being charged appropriately.

An exit interview was conducted and a copy of this report was provided to Anna Pastora.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle Reed	TELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2