565850168-10-10-2022-29-AS-DPEA-CMLQPD-20221230112035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850168
Report Date: 10/10/2022
Date Signed: 10/10/2022 03:56:07 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
10/05/2022 and conducted by Evaluator Kelly Dulek

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20221005100014

FACILITY NAME:	OAKMONT OF RIVERPARK		FACILITY NUMBER:	565850168
ADMINISTRATOR:	ERIC MENSAH		FACILITY TYPE:	740
ADDRESS:	901 TOWN CENTER DRIVE		TELEPHONE:	(805) 940-0390
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	140	CENSUS: 88	DATE:	10/10/2022
		UNANNOUNCED	TIME BEGAN:	10:53 AM
MET WITH:	Chris Andersen		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff are violating residents' personal rights

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Kelly Dulek and Diego Cortez conducted an unannounced initial complaint investigation for the allegation listed above. LPAs arrived at the facility at 10:53AM and met with Executive Director (ED) Chris Andersen. Entrance interview conducted.

During today's visit, LPAs toured the facility with Health Services Director Silvia Williams at 11:30AM, conducted a file review beginning at 12:05PM, interviewed residents from 12:46PM to 01:30PM, and interviewed staff at 12:26PM and between 01:34PM and 02:32PM. The following was then determined:

It was alleged that facility staff are violating residents' personal rights by waking Memory Care residents early in the morning. Record review revealed that residents nor their POAs have specified a morning wake up time in their plan of care. Interviews revealed that recently there was a change in the number of
Report Continued on LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20221005100014

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: 10/10/2022

NARRATIVE

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care staff working in the Memory Care unit on a daily basis. When the change occurred, NOC staff were instructed by management to wake Memory Care residents beginning at 4:00AM. Staff and resident interviews revealed that some residents wake on their own, but the majority of residents are woken up in the morning. After waking the residents, staff then assist the residents with their Activities of Daily Living prior to breakfast time. Staff indicated that there are 3 care staff scheduled at a time during the morning and evening shifts and there are 29 residents currently in memory care. Therefore, each caregiver has 9 or 10 residents to assist during their shift. Interview revealed that residents do not wish to be woken up early and staff stated residents are difficult to wake. Based on interview and record review, the allegation that "staff are violating residents' personal rights" is deemed SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D):

Exit interview was conducted with ED Andersen. A copy of the report and appeal rights were provided via email.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20221005100014

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/10/2022 Section Cited CCR 87468.1(a)(3)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities (a)(3) To be free from punishment...or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Exectutive Director agreed to no longer wake residents from sleep, unless requested in writing by the resident or their responsible person(s). Staff will be trained on resident personal rights section 87468.1. Proof of training will be sent to CCL by 10/17/2022.
	8 9 10 11 12 13 14	Based on interview and record review, the licensee did not comply with the above section, as staff are instructed to wake residents beginning at 4:00AM, which poses an immediate personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

LIC9099 (FAS) - (06/04)

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