565850291-4-14-2025-29-AS-KBUY-DG7P8W-20250429110613

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850291
Report Date: 04/14/2025
Date Signed: 04/14/2025 03:15:55 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
03/12/2025 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20250312141224

FACILITY NAME:	OAKMONT OF SIMI VALLEY		FACILITY NUMBER:	565850291
ADMINISTRATOR:	CHRISTINA SPEARS		FACILITY TYPE:	740
ADDRESS:	3110 ROYAL AVE		TELEPHONE:	(949) 744-5200
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	121	CENSUS: 87	DATE:	04/14/2025
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Christina Spears		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff did not provide residents with adequate food services.

Staff did not follow proper personal hygiene protocols.

Staff did not provide adequate laundry services to residents.

Staff did not maintain a comfortable temperature for resident(s).

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to investigate the allegations listed above. During today’s visit, LPA met with Executive Director Christina Spears and explained the reason for the visit.
On 03/14/2025, the initial complaint visit was conducted by LPA between approximately 12:30 p.m. - 02:30 p.m. During the visit, LPA’s conducted physical plant, interviewed staff, as well as, reviewed and obtained copies of pertinent documentation relevant to the investigation. Today LPA conducted interviews with staff and reviewed and obtained copies of additional pertinent documentation relevant to the investigation.

It was reported that "Staff did not provide residents with adequate food services" as it was alleged that the food that has been served was inadequate at oftentimes served late.Interviews conducted with eight (8) staff members revealed all eight (8) reported that food has always been delivered to the memory care in a timely manner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

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 3

Control Number 29-AS-20250312141224

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 SIMI VALLEY	FACILITY NUMBER: 565850291
	VISIT DATE: 04/14/2025

NARRATIVE

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Staff stated that meals typically include a variety of options such as scrambled eggs, soups, sandwiches, various proteins, salads, and other entrees requested by residents. None of the staff reported observing any food that appeared to be unappetizing or lacking in nutritional value. During the visit LPA observed that the main kitchen was adequately stocked with fresh fruits, as well as other perishable and non-perishable food items. All food was properly stored. In addition, interviews were conducted with three (3) family members or responsible parties of current residents. None of the individuals interviewed expressed any immediate or potential concerns regarding the quality of the food or the food service at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Residents in care are not provided proper meal service” is deemed Unsubstantiated at this time.

It was reported that "Staff did not follow proper personal hygiene protocols", as it was alleged that staff are not washing their hands, not wearing gloves and hair nets when serving food.
Interviews were conducted with eight (8) staff members revealed all eight (8) reported that staff consistently follow proper hygiene protocols. None of the individuals interviewed could recall any instance where food was served to residents without proper hand hygiene being observed. Additionally, no concerns were raised by staff regarding any current issues with hand hygiene practices. During physical plant tours conducted on 03/14/2025 and 04/14/2025 during lunch service, the LPA observed that all staff were wearing appropriate attire while serving food to residents. Interviews were also conducted with three (3) family members or responsible parties of residents in care. None of the individuals interviewed reported any immediate or potential concerns related to staff hygiene practices at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not follow proper personal hygiene protocols” is deemed Unsubstantiated at this time.

It was reported that "Staff did not provide adequate laundry services to residents", as it was alleged that due to staff negligence, laundry is piled high in multiple locations and residents are often returned the wrong clothes. Interviews were conducted with eight (8) staff members revealed, six (6) out of the eight (8) reported that they have not observed a significant accumulation of laundry in resident rooms or in the laundry area. Two (2) staff members stated they had observed large amounts of laundry on a few occasions; however, they noted this had not occurred since the beginning of the year.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250312141224

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 SIMI VALLEY	FACILITY NUMBER: 565850291
	VISIT DATE: 04/14/2025

NARRATIVE

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These staff attributed the temporary buildup to instances where multiple residents had soiled their bedding overnight. All eight (8) staff members confirmed that, while residents’ clothing can occasionally be mixed up, such occurrences are rare. Staff reported being familiar with which clothing items belong to which residents, helping minimize such issues. A review of facility records showed that laundry is typically completed by the morning shift for residents scheduled to receive showers. The PM and NOC (night) shifts complete laundry for residents not served during the morning or according to the facility's established laundry schedule. During physical plant tours conducted on 03/14/2025 and 04/14/2025, the LPA did not observe any excessive or uncollected laundry on the memory care floor. Additionally, interviews with three (3) family members or responsible parties of residents in care revealed that none of them expressed any current or potential concerns regarding the adequacy of laundry services. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not provide adequate laundry services to residents” is deemed Unsubstantiated at this time.

It was reported that "Staff did not maintain a comfortable temperature for residents" as it was alleged that staff oftentimes leave windows open in residents rooms at night. Interviews with eight (8) staff members indicated that none had observed any windows left open overnight or for an extended period without a resident’s request. Staff reported that, as part of their routine, both the PM and NOC (night) shifts conduct joint walk-through of resident rooms before residents go to sleep. During these checks, staff confirm that trash is not overflowing, windows are secured, and residents’ needs are being met. Interviews with three (3) family members or responsible parties of residents revealed that none expressed any immediate or potential concerns regarding staff maintaining a comfortable indoor temperature for residents at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not maintain a comfortable temperature for residents” is deemed Unsubstantiated at this time.

Exit interview conducted and copy of report issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

LIC9099 (FAS) - (06/04)

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