306005740-12-18-2023-22-AS-AORZ-CYQMZZ-20231221090356

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005740
Report Date: 12/18/2023
Date Signed: 12/18/2023 11:49:41 AM

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
07/05/2022 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220705155653

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: 95	DATE:	12/18/2023
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Alyson Caluza		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Resident is not getting proper nutrition.

Staff failed to provide care and supervision.

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegations mentioned above and for the purpose of delivering findings. LPA met with Wellness Director (WD) Alyson Caluza and explained the purpose of the inspection.

Interviews were conducted with six facility staff and five residents regarding allegation resident is not getting proper nutrition. Interviews conducted with six out six staff could not corroborate this allegation, as all staff interviewed acknowledged R1 was on a special diet and reported assisting him as needed at mealtimes. Interviews conducted with five out of five residents also could not corroborate allegation. Four out of five residents reported no complaints regarding facility food or nutrition and stated they received sufficient food in quantity. One out of five residents was unable to confirm or deny allegation.

Per Physician’s Fax report dated 5/04/22 facility reported to R1’s Physician “difficulty swallowing noted.” Physician’s order was to “downgrade diet to pureed and regular fluids.” (Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

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 22-AS-20220705155653

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: 12/18/2023

NARRATIVE

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LPA Gutierrez reviewed facility progress notes for R1 which indicated between 5/22/22 to 6/222/22 R1 lost 10 lbs. Client Coordination Note Report dated 6/20/22, indicated staff reported R1, "does not eat his pureed diet." Physician was notified and requested a diet change. Physician's Fax Report dated 6/20/22, indicated current diet order was discontinued and Physician ordered "advance diet to mechanical soft diet and regular fluids. Finger foods ok to give as tolerated." LPA reviewed progress notes from May to June 2022, and all notes indicated staff continued to monitor resident.

Interviews were conducted with six facility staff and five residents regarding allegation staff failed to provide care and supervision. Reporting Party (RP) stated staff spend time on their phone or socializing and will ignore residents. Six out of six staff denied staff is not providing care and supervision and denied observing staff spending time on their phone or ignoring residents. Four out of five residents interviewed reported no complaints regarding staff and reported they are assisted as needed. One out of five residents interviewed was unable to confirm or deny allegation.

Initial 10-day inspection on 7/11/22 was conducted by LPA Sean Haddad. Per LPA Haddad, staff was responsive, tending to residents, and were not observed to be on their phones. During today’s inspection, LPA Gutierrez also did not observe any staff on their phones. Staff were observed engaging with residents in various activities, such as guided exercises, grooming, and setting up for lunch.

Based on observations, conflicting information received during interviews conducted, and after a review of R1’s doctor’s orders, weight log, and facility progress notes, LPA is unable to determine if resident was not getting proper nutrition or if staff failed to provide care and supervision. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegations are unsubstantiated.

An exit interview was conducted with WD and copy of this report was provided at the end of the inspection.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

LIC9099 (FAS) - (06/04)

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