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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850168
Report Date: 12/07/2023
Date Signed: 12/07/2023 05:51:52 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2022 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20221205110809
FACILITY NAME:OAKMONT OF RIVERPARKFACILITY NUMBER:
565850168
ADMINISTRATOR:JASON RUSSOFACILITY TYPE:
740
ADDRESS:901 TOWN CENTER DRIVETELEPHONE:
(805) 940-0390
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:140CENSUS: 89DATE:
12/07/2023
UNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Chris Andersen, Executive DirectorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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9
Due to lack of supervision, resident fell, resulting in injury.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Zabel Chochian conducted unannounced subsequent visit to the above listed facility. The purpose of today’s visit is to conclude an investigation initiated by LPA Kelly Dulek on 12/14/2022. During today’s visit, LPA met with Executive Director Chris Andersen and the purpose of the visit was explained. Entrance interview conducted.

During the initial 10-day visit on 12/14/2022, LPA Dulek interviewed staff from approximately 1:20 PM to 1:45 PM, toured the facility with the Executive Director and Memory Care Director at approximately 1:45 PM, and obtained copies of pertinent documents. A subsequent visit was conducted by LPA Zabel Chochian on 2/09/2023, additional staff were interviewed from approximately 11:30 AM to 3:45 PM; LPA toured the Memory Care at approximately 4pm with staff and residents were observed and interviews were attempted during the tour. Additional interviews were conducted on 11/1/2023, 11/13/2023 and 12/06/2023 with potiential witnesses. (Continue to LIC9099c)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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 5
Control Number 29-AS-20221205110809
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF RIVERPARK
FACILITY NUMBER: 565850168
VISIT DATE: 12/07/2023
NARRATIVE
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It was alleged that due to lack of supervision, Resident #2 (R2) fell and sustained an injury. It was further reported that R2 sustained an injury to the right eye and a fracture in the right shoulder. This allegation was previously referred to Community Care Licensing Division’s Investigation Branch (IB) and assigned to Investigator Douglas Real (Complaint Control # 29-AS-20220906140504). The Department issued Substantiated findings on 02/09/2023. Deficiencies and civil penalties were also issued at the time of the visit; therefore, no citations will be issued during today’s visit.

Exit interview conducted and copy of report issued.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2022 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20221205110809

FACILITY NAME:OAKMONT OF RIVERPARKFACILITY NUMBER:
565850168
ADMINISTRATOR:JASON RUSSOFACILITY TYPE:
740
ADDRESS:901 TOWN CENTER DRIVETELEPHONE:
(805) 940-0390
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:140CENSUS: 89DATE:
12/07/2023
UNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Chris Andersen, Executive DirectorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff handled resident roughly, resulting in injury.
Staff do not ensure resident receives meals.
Staff leaves residents unattended.
Staff do not ensure residents receive showers.
INVESTIGATION FINDINGS:
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2
3
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5
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11
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13
Licensing Program Analyst (LPA) Zabel Chochian conducted unannounced subsequent visit to the above listed facility. The purpose of today’s visit is to conclude an investigation initiated by LPA Kelly Dulek on 12/14/2022. During today’s visit, LPA met with Executive Director Chris Andersen and the purpose of the visit was explained. Entrance interview conducted.

During the initial 10-day visit on 12/14/2022, LPA Dulek interviewed staff from approximately 1:20 PM to 1:45 PM, toured the facility with the Executive Director and Memory Care Director at approximately 1:45 PM, and obtained copies of pertinent documents. A subsequent visit was conducted by LPA Zabel Chochian on 2/09/2023, additional staff were interviewed from approximately 11:30 AM to 3:45 PM; LPA toured the Memory Care at approximately 4 PM with staff and residents were observed and interviews were attempted during the tour. Additional interviews were conducted on 11/1/2023 and 11/13/2023 with potential witnesses.
Following is a summary of the investigation findings: (Continue to 9099c)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20221205110809
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF RIVERPARK
FACILITY NUMBER: 565850168
VISIT DATE: 12/07/2023
NARRATIVE
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Regarding allegation, “Staff handled resident roughly, resulting in injury” – The reporting party alleged that staff #1(S1) handled Memory Care residents roughly. It was alleged that S1 pushed Resident #1’s (R1s) wheelchair very hard and R1s shin hit the wheelchair's footrest, which caused a skin tear (date and time of the alleged incident is unknown). It was also alleged that R1 is often bruised or with small unexplained skin tears. Interviews conducted and documents reviewed reflected R1 would be agitated and combative when staff would try to assist; therefore, staff would let R1 calm down and would go back at a later time to assist. Interviews further reflected that staff did not force R1 with anything. Staff also mentioned that R1 would bruise easily; however, did not recall specific injury incident as alleged. LPA attempted to contact Staff #1 (S1) on 11/03/2023 at 3 PM and on 11/6/2023 at 10 PM and 2 PM, however was unsuccessful.

Additionally, on 11/02/2023, at approximately 3:30 PM, LPA contacted the Reporting Party (RP) for additional details; however, RP did not have any further details to provide. Moreover, documents reviewed did not reflect the alleged incident/injury. LPA also attempted to interview random residents in the memory care unit, however they were unable to communicate due to cognitive decline. Potential witness/families of residents interviewed did not reveal any rough handling or mistreatment by staff towards residents. Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff handled resident roughly, resulting in injury” is deemed UNSUBSTANTIATED at this time.

Regarding allegation, “Staff do not ensure resident receives meals” - The complainant alleged that staff do not get R1 up for breakfast or lunch; staff often leave R1 in bed hungry until 01:00 PM. Staff interviewed reported that R1 was receiving hospice services, did not have an appetite and usually did not get up for breakfast. Therefore, R1 was provided with a meal when R1 was awake and ready to eat. Staff interviewed denied the allegation that “staff do not ensure resident receives meals”. Staff reported that all residents are provide three (3) meals a day including snacks in between meals. During initial visit and subsequent visits to the facility, LPA observed the dining room area in Memory Care and observed residents eating. Potential witness/families interviewed did not express any concern with residents receiving meals. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff do not ensure resident receives meals” is deemed UNSUBSTANTIATED at this time. (Continue to LIC9099c)
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20221205110809
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF RIVERPARK
FACILITY NUMBER: 565850168
VISIT DATE: 12/07/2023
NARRATIVE
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Regarding allegation, “Staff leaves residents unattended” – It was alleged that S1 leaves Resident #3 (R3) unattended for 2-hour time periods. It was further reported that staff take resident out in wheelchairs in front of the television then not check on resident for at least 2 hours at a time. Interviews with staff revealed that residents are provided with time to watch television and are checked multiple times throughout the day by staff on the floor. Staff reported that residents are within eyesight when in the common area. Staff stated that if a resident is in the room resident is checked on at least every two (2) hours by staff. Staff interviewed reported that residents are not left unattended and are checked on regularly. Potential witnesses interviewed stated that they have observed staff in the common areas of the memory care unit watching residents. It was reported that staff are observed on the floor in the common areas throughout the day. No issues or concerns were reported at the time of the interviews. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff leaves residents unattended” is deemed UNSUBSTANTIATED at this time.

Regarding allegation, “Staff do not ensure residents receive showers” - Information was received that memory care unit residents are not being showered regularly. It was alleged that some of the staff aren't offering showers to the residents and are just writing that residents refuse to shower so they don't have to shower the residents. Staff interviewed denied the allegation and reported that showers are provided to residents and if the resident is combative and or refuse, they will not force the resident to shower. Staff interviews revealed that refusal of any services including, but not limited to, shower refusal is always documented. Staff denied the allegation of falsely documenting shower refusal for any resident. Staff reported if a resident constantly refuses to shower it is reported to management and family. During the initial and subsequent visits LPAs toured the facility’s memory care unit. Residents in the common area observed appeared to be clean and dry. Sample shower logs observed during initial and subsequent visit documented residents shower refusal. Other records reviewed at the facility revealed that hospice residents receive showers from the hospice agency twice a week. Potential witnesses interviewed did not report any unmet hygiene needs of residents.

Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff do not ensure residents receive showers” is deemed UNSUBSTANTIATED at this time.

Exit interview conducted/No citations issued/ A copy of report was provided.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5