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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006005
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:14:47 PM

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 HUNTINGTON BEACHFACILITY NUMBER:
306006005
ADMINISTRATOR:YOUNAN, HEATHERFACILITY TYPE:
740
ADDRESS:18922 DELAWARE STREETTELEPHONE:
(657) 204-4600
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:111CENSUS: 72DATE:
12/09/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Heather Younan, AdministratorTIME COMPLETED:
02:30 PM
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On this day, LPAs Kevin Saborit-Guasch and Jenifer Tirre made an unannounced case management visit for the purpose of following up on an incident report submitted to the Regional Office regarding a fire at the facility that occurred on 12/06/2021. They were greeted by Administrator Heather Younan after going through the facility's COVID-19 screening procedure.

At approximately 7pm on 12/06/2021, the facility made a call to 911 to report a fire in the Memory Care floor laundry room. A drier in the room continued operating in wrinkle-guard mode unattended after being used earlier in the afternoon, which likely resulted in the machine overheating and initiating the fire, which triggered the alarm and sprinkler system, which contained the fire.

The 23 memory care residents from the first floor were evacuated to a courtyard on the same level while the Assisted Living residents from the second and third levels were evacuated through one available stairwell since the other stairwell was in close proximity to the location of the incident.

An evacuation drill had been conducted with both staff and residents in July 2021 while staff evacuation exercises are conducted bi-monthly. Residents were able to return to the facility by 8:15pm. Administrator indicated that no smoke inhalation or resident property damage were observed. The laundry room and equipment sustained considerable water damage from the sprinklers and are currently out of service.

Based on the observations made during today’s visit, no deficiencies were noted per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with Administrator and a copy of this report was provided and left at facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 287-4084
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: 714-703-2851
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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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