567609903-3-22-2023-29-AS-DPEA-CRBR27-20230428123751

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 567609903
Report Date: 03/22/2023
Date Signed: 03/22/2023 07:01:28 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
05/06/2021 and conducted by Evaluator Kelly Dulek

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20210506114631

FACILITY NAME:	OAKMONT OF CAMARILLO		FACILITY NUMBER:	567609903
ADMINISTRATOR:	LEATRICE BOGOYEVAC		FACILITY TYPE:	740
ADDRESS:	305 DAVENPORT STREET		TELEPHONE:	(805) 738-3600
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93012
CAPACITY:	0	CENSUS: 0	DATE:	03/22/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Bradlee Foerschner		TIME COMPLETED:	06:41 PM

ALLEGATION(S):

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Staff interfered with residents meals while in care
Staff are not addressing residents toileting needs
Residents are left soiled for an extended periods of time
Staff are not providing adequate care and supervision to residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced subsequent complaint inspection at the facility today. The LPA arrived at 11:00AM and initially met with Business Office Manager Kailey Vanderwall. Executive Director Bradlee Foerschner joined during the facility tour. The LPA informed both managers of the reason for today's inspection. Entrance interview conducted.

This report is being delivered to the current Executive Director Bradlee Foerschner, of Oakmont of Camarillo (LIC # 565850169) per prior approval of Susan McPherson, Senior Vice President of Regulatory Affairs for the management company.

During today’s visit, LPA toured the facility with Ms. Vanderwall at 11:04AM, interviewed staff at 11:42AM and 12:19PM, LPA observed lunch in the Memory Care unit at 12:09PM, and LPA conducted a medication review with ED and the Medication Technician at 12:52PM. During a previous visit which took place on
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: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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-20210506114631

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: 567609903
	VISIT DATE: 03/22/2023

NARRATIVE

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Continued from LIC 9099
05/12/2021, LPA conducted a facility tour with Business Office Manager at 10:08AM, an interview with the Administrator at 10:28AM, interviewed staff at 10:08AM and again from 12:02PM to 4:40PM, LPA observed lunch service and interviewed residents from 11:23AM to 12:00PM, and gathered copies of documents pertinent to the investigation. Throughout the course of the investigation, LPA reviewed pertinent documents. The following was then determined:

Regarding the allegation "Staff interfered with residents meals while in care:"
It was alleged that Staff #1 (S1) was throwing away residents' meals prior to the resident finishing their meal, without their consent as well as not assisting residents who require feeding assistance. Interviews were conducted with staff, who indicated the dining staff deliver the cart to memory care and the memory care staff serve the meals to residents. Breakfast is served between 08:00AM and 08:30AM, lunch is around 11:30AM, and dinner is about 04:30PM. Staff indicated there are 2 residents who do not come out of their rooms for meal times, but the care staff will deliver their covered meals to their rooms. Staff interviewed indicate most residents can feed themselves, but if a resident needs assistance, the staff assist them. During the initial complaint visit, LPA observed a staff sitting with a resident, assisting the resident with their meal. Staff stated there is "no time limit" for meals, that some residents "stay at the table for hours" and they let the residents finish their meals. During the subsequent complaint visit, LPA observed staff asking residents if they were through with their plate prior to the staff removing empty plates from the table. When a resident got up from the lunch table to use the restroom, staff saved the resident's plate and even offered to heat up the lunch when the resident returned. Residents interviewed indicated they were happy with the meals, they can eat as long as they would like and they get enough food. Based on interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation that "staff interfered with residents meals while in care" is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff are not addressing residents toileting needs:"
Interviews with staff revealed that the residents are all changed at the beginning of shift, after breakfast, before lunch, again after lunch and before the 02:00PM change of shift. Additional changes occur as needed, with staff checking on residents and asking if they need to be changed every 30 minutes to one hour. Residents interviewed indicated they are changed enough and feel their toileting needs are being met.
Report Continued on LIC 9099-C

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20210506114631

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: 567609903
	VISIT DATE: 03/22/2023

NARRATIVE

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Continued from LIC 9099-C...
Staff indicated that residents are all changed similarly during the evening shift, with scheduled changes every 2-3 hours and checking the residents every 30 minutes to one hour. During the NOC shift, residents are not woken to be changed, however, staff do change them just before bedtime and some residents do wake up and require changes overnight. If a resident refuses a change, another care staff, the medication technician, or the Memory Care Director will offer to change the resident. Interview revealed that usually a change of staff will elicit the resident to allow the care needs to be met. Based on interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation that "staff are not addressing residents toileting needs" is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "residents are left soiled for an extended periods of time:"
Interview with staff revealed that with the exception of overnight, residents are asked if they need to use the toilet or if they need to be changed approximately every 30 minutes. In addition, residents are checked every hour to ensure residents are not left soiled. Staff interview revealed that there is one resident who is a 2-person assist due to combativeness when staff attempt to change the resident. This resident sometimes refuses changes, but when they refuse, another staff will offer to assist. Staff interview also revealed that there are a handful of residents who are "heavy wetters" that have a greater than average urine output, filling their incontinence brief with each urination. Staff interview revealed that there are also a few residents who will urinate as soon as they have been changed, requiring a second change right away. At the time of the complaint, the newer staff were still learning to identify these residents and their unique needs, so it is possible residents may not have been changed right away, but they were never left more than 30 minutes soiled. Staff interview revealed that at change of shift, outgoing staff communicate with incoming staff if anyone needs to still be changed or if everyone is dry. Staff interviewed stated they have never seen any resident soaked through requiring a change of clothes. Therefore, based on interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred; as thus, the allegation that "residents are left soiled for extended periods of time" is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "staff are not providing adequate care and supervision to residents:"
It was alleged that staff are seen on their phones and not providing care and activities to the residents in Report Continued on LIC 9099-C

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20210506114631

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: 567609903
	VISIT DATE: 03/22/2023

NARRATIVE

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Continued from LIC 9099-C...
care. During the time the complaint was received, there were a number of staff who were resigning and new staff were being hired and trained. Interviews revealed that for memory care, during the day shift and evening shift, there are 3 caregivers scheduled. During the overnight (NOC) shift, 2 caregivers are scheduled. There are also an activities person scheduled during the day, as well as a medication technician during the day and evening shifts, and a shared medication technician on the NOC shift. Previously, with the more seasoned staff, they could have 2 caregivers scheduled during the day, but with the newer staff and the needs of the residents, the facility changed to 3 care staff. Residents interviewed indicated their needs are being met and the care provided is adequate. Staff observed during the facility tour were engaged with the residents, talking with them and interacting with them. Staff interview revealed that there have been occasions where staff are on their personal phones, but this did not impede with resident care and all residents' needs are tended to timely. Based on interview and observation, although the allegation may be valid, at this time there is insufficient evidence to support the allegation, therefore the allegation "staff are not providing adequate care and supervision to residents" is deemed UNSUBSTANTIATED at this time.

Exit interview conducted with ED Forschner. 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: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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