306005740-7-14-2025-22-AS-MSEY-DJMLS7-20250716090017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005740
Report Date: 07/14/2025
Date Signed: 07/14/2025 03:24:01 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
01/30/2023 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 22-AS-20230130113643

FACILITY NAME:	OAKMONT OF ORANGE		FACILITY NUMBER:	306005740
ADMINISTRATOR:	ALYSON CALUZA		FACILITY TYPE:	740
ADDRESS:	630 THE CITY DRIVE SOUTH		TELEPHONE:	(714) 880-8624
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY:	155	CENSUS: 105	DATE:	07/14/2025
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Alyson Womack		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Resident sustained fractures while in care due to neglect.
Staff failed to seek resident medical attention in a timely manner.
Insufficient staffing to meet residents' needs.
Staff failed to respond to resident's call assistance button in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced and met with Health Services Director (HSD) Alyson Womack to deliver findings for the above complaint allegations.

During the investigation, the department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

***Report continued on 9099-C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025

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 22-AS-20230130113643

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: OAKMONT OF ORANGE	FACILITY NUMBER: 306005740
	VISIT DATE: 07/14/2025

NARRATIVE

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Allegation: Resident sustained fractures while in care due to neglect.-Unsubstantiated

Resident #1 (R1) was not documented as a fall risk and did not require two- hour checks. R1 stated their fall occurred in their room without any witnesses in October 2022. When staff did respond to the fall, R1 confirmed they refused to be transported to the medical center for further assessment.

Allegation: Staff failed to seek resident medical attention in a timely manner.-Unsubstantiated

In an interview with R1 they confirmed they refused to be transported to a medical center for further assessment of injury after their fall in October 2022. Facility did keep records of R1 reporting they had no pain in the following days. R1 did not inform staff that they were going to the doctors due to an injury after the fall. R1 was found to have a “minimally displaced fracture of undetermined age.” Records reviewed documented R1 as having a pathological fracture. Consulting physicians explained this type of fracture implies the fracture was a result of underlying illness of disease.

Allegation: Insufficient staffing to meet residents' needs. - Unsubstantiated

The department conducted interviews with staff and residents. Staff interviews indicated they feel like they have enough staff to meet the needs of the residents in care. Resident interviews indicated that some residents feels like their needs are being met. While others feel like their needs to be more checks throughout the day. LPA conducted a tour of the facility and observed multiple staff members on the floors assisting residents.

Allegation: Staff failed to respond to resident's call assistance button in a timely manner. - Unsubstantiated

A sample of resident call button response logs was reviewed for the last few weeks. Staff are to respond to pages within twenty (20) minutes, but they normally respond under ten (10) minutes. Residents interviewed stated it can take any where from fifteen (15) to thirty (30) minutes. Staff interviews indicated that staff usually respond to resident’s call buttons right away unless they are with another resident. If staff forget to clear the call button after they respond they are to document that in the shift reports.

Based upon the information obtained during investigation, the above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted a copy of the report and appeal rights were left at the facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025

LIC9099 (FAS) - (06/04)

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