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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006005
Report Date: 09/20/2024
Date Signed: 09/20/2024 03:35:03 PM


Document Has Been Signed on 09/20/2024 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 HUNTINGTON BEACHFACILITY NUMBER:
306006005
ADMINISTRATOR:ACOSTA-LOUER, SANDRAFACILITY TYPE:
740
ADDRESS:18922 DELAWARE STREETTELEPHONE:
(657) 204-4600
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:111CENSUS: 69DATE:
09/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
07:08 AM
MET WITH:Executive Director, Christine GreenwayTIME COMPLETED:
03:45 PM
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On 9/20/2024, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted and granted entry by staff after stating the purpose of the visit. Executive Director (ED) Christine Greenway arrived to the facility to assist with inspection on today's date.

The facility is licensed for one hundred eleven (111) non-ambulatory residents, eight (8) Bedridden with approved hospice waiver for fifteen (15) residents. Currently, there are nine (9) Hospice residents present during today’s visit.

Facility is a three story building plus basement housing 44 apartments in the assisted living and 32 apartments in the memory care unit. At 9:00AM LPA toured inside and outside physical plant with Executive Director and reviewed staff files, observed emergency food & water, recorded water temperatures, began inspection tool kit, began resident interviews and observed Liability insurance, fire drill and observed Annual Fire Inspection logs.

Due to time constraints, Annual Inspection needs a follow up visit to complete full inspection. LPA will conduct a follow up visit to complete inspection.

LPA conducted exit interview with Executive Director Christine Greenway

SUPERVISOR'S NAME: Lourdes MontoyaTELEPHONE: (714) 703-2870
LICENSING EVALUATOR NAME: Jenifer TirreTELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024
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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