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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609903
Report Date: 05/12/2021
Date Signed: 05/14/2021 08:46:54 AM

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
05/07/2021 and conducted by Evaluator Kelly Dulek
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20210507112047
FACILITY NAME:OAKMONT OF CAMARILLOFACILITY NUMBER:
567609903
ADMINISTRATOR:LEATRICE BOGOYEVACFACILITY TYPE:
740
ADDRESS:305 DAVENPORT STREETTELEPHONE:
(805) 738-3600
CITY:CAMARILLOSTATE: CAZIP CODE:
93012
CAPACITY:150CENSUS: 90DATE:
05/12/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lea BogoyevacTIME COMPLETED:
06:55 PM
ALLEGATION(S):
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Facility doesn’t have an emergency disaster plan that addresses power outages.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint inspection at the facility today. The LPA arrived at 10:00 AM and initially met with Business Office Manager Kailey Vanderwall. Administrator Lea Bogoyevac arrived at 10:28AM. The LPA informed the Administrator of the reason for today's inspection.

During today's visit, LPA Dulek conducted a facility tour with Business Office Manager Kailey Vanderwall at 10:08AM, an interview with the Administrator at 10:28AM, interviewed staff at 10:08AM and again from 12:02PM to 4:40PM and gathered copies of documents pertinent to the investigation. The following was then determined:

LPA reviewed a copy of the facility's Emergency Disaster Plan dated 10/1/2020 and updated on 1/25/2021 and interviewed the Administrator. LPA determined the facility does have a generator and has written plans,
Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion: 30
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021
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-20210507112047
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: 05/12/2021
NARRATIVE
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for situations involving power outages. Based on interview and record review, there is insufficient evidence to support the allegation, therefore the allegation "facility doesn't have an emergency disaster plan that addresses power outages" is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. A copy of the report and appeal rights were provided via email.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2021
LIC9099 (FAS) - (06/04)
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