565850168-1-31-2023-29-AS-JAPL-CP4M6M-20230216082006

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850168
Report Date: 01/31/2023
Date Signed: 01/31/2023 06:09:26 PM

Unsubstantiated

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
04/05/2022 and conducted by Evaluator Kelly Dulek

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20220405094555

FACILITY NAME:	OAKMONT OF RIVERPARK		FACILITY NUMBER:	565850168
ADMINISTRATOR:	BERGAN, KIM		FACILITY TYPE:	740
ADDRESS:	901 TOWN CENTER DRIVE		TELEPHONE:	(805) 940-0390
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	140	CENSUS: 90	DATE:	01/31/2023
		UNANNOUNCED	TIME BEGAN:	10:47 AM
MET WITH:	Chris Andersen		TIME COMPLETED:	06:10 PM

ALLEGATION(S):

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Facility is not making the disaster plan available to residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted a subsequent complaint investigation for the allegation listed above. LPA met with facility Executive Director (ED) Chris Andersen and explained the reason for today's visit.

During today's visit, LPA conducted an interview with ED at 10:50AM, staff interviews at 10:57AM and from 11:33AM to 01:20PM, tour of the facility along with Executive Director at 11:22AM, medication review at 01:22PM and resident interviews from 01:41PM to 03:02PM. During a visit conducted on 10/10/2022, LPA Dulek and LPA Diego Cortez toured the facility at 11:30 AM with staff Sylvia Williams and obtained copies of pertinent documents. During an intial complaint visit conducted on 04/14/2022, LPA Rosales toured the facility with staff Jorge Moreno, interviewed random resident and staff and obtained copies of pertinent documents. Throughout the course of the investigation, LPA Dulek reviewed pertinent documentation. The following was then determined:
Report Continued on LIC 9099-C

Unsubstantiated

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: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

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-20220405094555

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: 01/31/2023

NARRATIVE

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During today's visit, LPA Dulek took photographs of Oakmont of Riverpark's policies pertaining to the Emergency Disaster Manual. LPA observed a framed letter both on the wall with the facility's license, as well as in a free-standing frame on a side table in the facility lobby indicating "a copy of the Emergency Disaster Manual is available upon request at the Concierge Desk." LPA also observed the Emergency Disaster Manual binder at the concierge desk. All 6 of 6 residents interviewed indicate they have conducted disaster drills multiple times in the time they have resided at the facility. Residents stated they are aware and have practiced the emergency disaster protocol and have seen paperwork relating to how to respond in case of an emergency. Staff interviewed during LPA Rosales' initial visit had mixed responses. Some were aware of the emergency disaster plan and indicated they had participated in disaster drills during their employment, others were not. Executive Director provided LPA with documentation of emergency disaster training conducted with staff. Based on interview and record review, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation that "Facility is not making the disaster plan available to residents" is deemed UNSUBSTANTIATED at this time.

Exit interview conducted with ED Andersen. A copy of the report was provided.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC9099 (FAS) - (06/04)

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