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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 312700863
Report Date: 10/20/2022
Date Signed: 10/20/2022 12:59:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/21/2022 and conducted by Evaluator Kerry Hiratsuka
COMPLAINT CONTROL NUMBER: 25-AS-20220321111441
FACILITY NAME:OAKMONT OF WESTPARKFACILITY NUMBER:
312700863
ADMINISTRATOR:CASSIANA BUSHFACILITY TYPE:
740
ADDRESS:2400 PLEASANT GROVE BLVDTELEPHONE:
(916) 789-2000
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:142CENSUS: 88DATE:
10/20/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Jeff Sumabat, Regional Ops SpecialistTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff ignoring resident call pages
Residents are being neglected
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kerry Hiratsuka arrived at the facility unannounced to deliver the findings of the allegations above. LPA wore a surgical mask during visit. This complaint came in March 2022.

LPA investigated the allegation “1. Staff ignoring resident call pages; 2. Residents are being neglected.” LPA interviewed facility staff, residents, and reviewed facility documentation.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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 25-AS-20220321111441
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: OAKMONT OF WESTPARK
FACILITY NUMBER: 312700863
VISIT DATE: 10/20/2022
NARRATIVE
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1. Staff also stated they answer all call pendants and LPA was unable to interview the resident in question because the resident refused to be interviewed during LPA’s attempts. LPA reviewed the call log and observed that several stated they calls went unanswered on both the assisted living side and memory care side. The residents interviewed on the assisted living side state the calls are answered. LPA was informed the caregivers wear a pendant that clears the call requests from the residents and that the building was down to only a couple for the memory care and assisted living side for awhile and management was not made aware of the issue until August 2022. LPA was told that sometimes the caregivers don’t turn off the call pendant because they focus on the resident first when responding to the call pendant and forget to turn off the call pendant. More pendants for the caregivers have been ordered and are ordered on a regular basis. Other interviews stated the staff ignore the call button for a particular resident which staff deny, and LPA was unable to interview that resident. Because each side has their own version of events LPA cannot prove or disprove the allegation.

2. LPA toured the memory care unit on 09/07/2022, 08/17/2022, 05/21/2022, 05/17/2022, and 03/23/2022. LPA did not see any residents being neglected. All appeared to be clean and did not observe any odors. LPA attempted to interview the resident in question, but the resident refused to be interviewed. LPA interviewed residents on the assisted living side, and they have no issues with caregivers. The facility was very dependent on agency staff for a long time and LPA cannot determine if there were any issues with the agency staff regarding resident care. LPA cannot prove or disprove the allegation above based on the information obtained.

Allegations cannot be proved or disproved based on the interviews, review of facility records, and observation. Allegations are unsubstantiated.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2