366426338-2-2-2024-56-AS-EMAN-D2UNWG-20240227094928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366426338
Report Date: 02/02/2024
Date Signed: 02/02/2024 10:51:04 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
09/26/2023 and conducted by Evaluator Paola Guerrero

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230926082949

FACILITY NAME:	OAKMONT OF SAN ANTONIO HEIGHTS		FACILITY NUMBER:	366426338
ADMINISTRATOR:	SAMUEL DE GUZMAN		FACILITY TYPE:	740
ADDRESS:	2419 N EUCLID AVE		TELEPHONE:	(909) 981-4002
CITY:	UPLAND	STATE: CA	ZIP CODE:	91786
CAPACITY:	140	CENSUS: 80	DATE:	02/02/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Cheryl Stevenson		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff does not answer residents' call buttons in a timely manner due to
inadequate staffing.
Staff does not ensure resident's showering needs are being met.
Staff does not ensure resident's restroom needs are being met.
Staff is overcharging residents for services not received.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Administrator Cheryl Stevenson and explained the purpose of the visit. The investigation consisted of interviews and review of records.

First allegation, Staff does not answer residents' call buttons in a timely manner due to inadequate staffing. During interviews and review of records LPA observed Resident#1 history alerts which displayed staff to be answering Resident#1 alerts on a timely manner. In addition, LPA obtained facility roster and observed that facility has adequate staffing for every shift to meet resident’s needs.

Second allegation, Staff does not ensure resident's showering needs are being met. During interviews and review of records LPA observed that Resident #1 showering needs are being met. LPA conducted interviews with residents which all stated that their showering needs are being met.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

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-20230926082949

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 SAN ANTONIO HEIGHTS	FACILITY NUMBER: 366426338
	VISIT DATE: 02/02/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Third allegation, Staff does not ensure resident's restroom needs are being met. During interviews and review of records LPA observed that Resident #1 restroom needs are being met. LPA conducted interviews with residents which all stated that their restroom needs are being met.

Fourth allegation, Staff is overcharging residents for services not received. Based on review of records LPA reviewed Residents #1 admission agreement along with needs and service plan and observed that Resident #1 is being charged for the services listed on residents’ admission agreement. LPA did not observe overcharge fees in resident record. LPA conducted interviews with residents, and all stated that they have not experienced any issues with services at the facility nor have they ran into any problems regarding over charge fees. Based on the evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated.

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 Administrator Cheryl Stevenson at the end of the visit.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Paola Guerrero	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2