567609903-10-20-2022-29-AS-DPEA-CKKQ2Q-20221026114731

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 567609903
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:49:15 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
01/25/2021 and conducted by Evaluator Kasandra Lopez

COMPLAINT CONTROL NUMBER: 29-AS-20210125101938

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:	10/20/2022
		UNANNOUNCED	TIME BEGAN:	02:11 PM
MET WITH:	Susan McPherson		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Facility is without electricity.
Licensee failed to notify responsible party of incident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced telephonic interview with Susan McPherson, Senior Vice President of Regulatory Affairs for Oakmont Management Group to deliver findings regarding the above allegations. The facility closed effective 10/21/2021 and the property was re-licensed under a new licensee.

On 01/25/2021, Community Care Licensing Division received a complaint that alleged on 01/19/2021, the facility did not have electricity and Resident #1's (R1) responsible party was not notified of the power outage.On 02/01/2021, LPA Lopez initiated the investigation. An interview was conducted with the Administrator Leatrice Bogoyevac and a virtual inspection was conducted via face time. During the inspection, LPA observed the facility generator to currently be in an outside storage room. The LPA also requested pertinent documentation to be emailed to the LPA.
Report continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Kasandra Lopez	TELEPHONE: (818) 421-5183
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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-20210125101938

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: 10/20/2022

NARRATIVE

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Interviews with the Administrator revealed the facility was without power for two days due to an issue with the electric company. The first night, the on site generator powered part of the kitchen including the refrigerator and freezer, the hallways and some outlets. She said staff were also posted at all exits with flashlights.

The following day, a larger generator was rented which provided additional power for the facility until power was restored. The Administrator stated the facility had a phone tree and the family member or POA for every resident was notified of the power outage.

A review of the facility's Emergency and Disaster Plan (LIC 610E), stated the facility's provision for emergency power would be that the community would have small generator on site that could be used for emergency lighting, fans, heaters and emergency equipment until a larger generator could be rented from a local store.

A review of facility records revealed Individual #1 (I1) was listed as R1's primary emergency contact and Individual #2 (I2) was identified as R1's alternate emergency contact. The Administrator provided a screen shot of a cell phone call which indicated the telephone number for I2 based on R1's emergency contact information, was contacted on 01/19/2021 at 20:02 and the phone call lasted five minutes.

Based on the information obtained, the facility followed their Emergency and Disaster Plan following the power outage and a responsible party for R1 was contacted on the day of the power outage. Therefore, the allegations of ‘Facility was without electricity’ and 'Licensee failed to notify responsible party of the incident' are unsubstantiated at this time.

Exit interview and report findings reviewed with Ms. McPherson. A copy of the report was emailed for signature.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Kasandra Lopez	TELEPHONE: (818) 421-5183
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC9099 (FAS) - (06/04)

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