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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881162
Report Date: 06/14/2024
Date Signed: 06/14/2024 10:48:15 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/09/2024 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240209102015
FACILITY NAME:OAKMONT OF CHINO HILLSFACILITY NUMBER:
361881162
ADMINISTRATOR:MEDRANO, JANETHFACILITY TYPE:
740
ADDRESS:14837 PEYTON DRIVETELEPHONE:
(909) 606-3010
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:170CENSUS: 139DATE:
06/14/2024
UNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Janeth MedranoTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Licensee did not refund preadmission fees.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Facility Director Janeth Medrano and explained the purpose of the visit. The investigation consisted of interviews and record review.

First allegation, Licensee did not refund preadmission fees. LPA conducted an interview with Facility Director Janeth Medrano who explained that a refund check to Resident #1 was given on 2/7/2024. LPA Guerrero obtained a copy of Resident #1 Service Agreement document and observed the description and breakdown of the fees that were owed to the facility along with the total amount that will refunded back to Resident #1. Based on documentation LPA observed that Resident #1 personally picked-up a refund check at Oakmont of Chino Hills on 2/7/2024. Based on the evidence obtained during the course of the investigation, LPA has determined that the above allegation is Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola GuerreroTELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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 56-AS-20240209102015
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: OAKMONT OF CHINO HILLS
FACILITY NUMBER: 361881162
VISIT DATE: 06/14/2024
NARRATIVE
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Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Director Janeth Medrano.
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola GuerreroTELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2