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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609903
Report Date: 06/07/2023
Date Signed: 06/07/2023 03:47:03 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
07/23/2021 and conducted by Evaluator Kelly Dulek
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20210723163143
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:0CENSUS: 0DATE:
06/07/2023
UNANNOUNCEDTIME BEGAN:
01:33 PM
MET WITH:Bradlee Foerschner & Kailey VanderwallTIME COMPLETED:
03:55 PM
ALLEGATION(S):
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Resident developed a septic infection while in care
Unqualified staff providing wound care services
Staff did not administer medications to residents
Staff stealing resident's medications
Staff are not properly trained

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced subsequent complaint inspection at the facility today, with the purpose of delivering findings for the above listed allegations. The LPA arrived at 01:33PM and met with Business Office Director Kailey Vanderwall. The LPA informed the Business Office Director and Executive Director 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 an initial complaint visit conducted on 07/28/2021, LPA Dulek conducted an interview with Regional Executive Director Specialist, Regional Health Services Director and Executive Director at 12:55PM, conducted staff interviews from 2:28PM to 3:20PM and gathered copies of documents pertinent to the
Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
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-20210723163143
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: 06/07/2023
NARRATIVE
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investigation. Throughout the course of the investigation, LPA Dulek interviewed staff and other relevant parties during unrelated facility visits and LPA reviewed relevant documents. The following was then determined:

Allegations: “Resident developed a septic infection while in care” and “Unqualified staff providing wound care services:”

It was alleged that Resident #1 (R1) had developed a septic infection due to untrained medication technicians providing wound care for R1. Staff interviewed all indicated they do not do any wound care, only basic first aid, such as placing a bandaid for a resident. Additionally, interview revealed that R1 had home health care for the wounds on their heels, which was confirmed through record review. During the investigation, LPA discovered 2 (two) additional residents who were utilizing home health services to provide wound care. Interviews revealed that R1 did not have a septic infection, nor could staff recall any other resident with a septic infection. Based on interview and record review, at this time, there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegations that “resident developed a septic infection while in care” and “unqualified staff providing wound care services” is deemed UNSUBSTANTIATED at this time.

Allegations: “Staff did not administer medications to residents” and “Staff stealing residents’ medications:”

The complaint alleges that staff stole narcotic medications prescribed to residents instead of administering the medications to the residents. The complaint further alleges that when narcotics were missing, staff were asked by management to sign missing signatures on controlled substance log. Interviews revealed that residents do get their medications regularly as prescribed, as well as PRN medications as needed upon request. All staff interviewed indicated that they only sign off on medications they have administered and have not been asked to sign something when they did not personally administer a medication. Interviews revealed that there have been no reports of staff stealing medications and no medications “missing.” Controlled substance logs reviewed appeared consistent with medication administration records. Based on interview and record review, although the allegations may be valid, at this time there is insufficient evidence to support the allegations or that a violation occurred; therefore, the allegations that “staff did not administer medications to residents” and “staff stealing residents’ medications” is deemed UNSUBSTANTIATED at this time. Report Continued on LIC 9099-C

SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20210723163143
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: 06/07/2023
NARRATIVE
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Allegation: “Staff are not properly trained:”

It was alleged that Staff #1 (S1) was not trained prior to entering their role as a medication technician. During the course of the investigation, LPA reviewed training logs for S1 and other medication technician staff employed at the time of the complaint. Record review revealed that S1 was trained per regulation. Interviews revealed that staff do receive training. Training consists of videos and quizzes in an online system prior to interacting with residents. Following online training, the trainee then shadows a current senior employee in that role or the management staff training them prior to administering any medications themselves. All training records reviewed were in compliance with regulation. Based on record review and interview, there is insufficient evidence to support the allegation, therefore the allegation that “staff are not properly trained” is deemed UNSUBSTANTIATED at this time.

No citations were issued. Exit interview conducted. A copy of the report was provided.

SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3