565850169-9-15-2023-29-AS-KHEN-CVTLZZ-20230919091243

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850169
Report Date: 09/15/2023
Date Signed: 09/15/2023 05:38:08 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
09/08/2023 and conducted by Evaluator Kelly Dulek

COMPLAINT CONTROL NUMBER: 29-AS-20230908140024

FACILITY NAME:	OAKMONT OF CAMARILLO		FACILITY NUMBER:	565850169
ADMINISTRATOR:	FOERSCHNER, BRADLEE		FACILITY TYPE:	740
ADDRESS:	305 DAVENPORT STREET		TELEPHONE:	(805) 738-3600
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93012
CAPACITY:	150	CENSUS: 82	DATE:	09/15/2023
		UNANNOUNCED	TIME BEGAN:	04:10 PM
MET WITH:	Bradlee Foerschner		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Licensee did not provide resident's records as requested

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted an initial complaint investigation for the allegation listed above. LPA arrived at the facility at 04:10PM and met with Executive Director (ED) Bradlee Foerschner. Entrance interview conducted.

During today's visit, LPA interviewed ED at 04:18PM and LPA reviewed and obtained copies of documents pertinent to the investigation.

LPA reviewed the letter requesting former resident (R1)'s documents dated 09/06/2023 as well as the mailing receipt for the letter. Mailing receipt indicates overnight delivery with a delivery date of 09/07/2023 indicated. Interview with ED revealed that as soon as the envelope was opened, ED scanned and sent the request letter to the Oakmont legal team. Letter was scanned at 11:05AM on 09/07/2023. The ED then prepared and scanned all R1's requested documents to the Oakmont legal team for review on 09/08/2023. Oakmont legal 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: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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-20230908140024

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 CAMARILLO	FACILITY NUMBER: 565850169
	VISIT DATE: 09/15/2023

NARRATIVE

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team then released R1's records via email to the requesting party on Monday 09/11/2023 at 12:33PM. Interview with ED further revealed that these documents were previously requested by R1's family member on 07/03/2023, with a deadline for receipt on 07/06/2023, however ED had provided R1's family member with the documents early on 07/05/2023. Email receipt was provided to LPA during today's visit. 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 "Licensee did not provide resident's records as requested" is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. No citations issued. 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: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC9099 (FAS) - (06/04)

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