567609936-7-16-2021-29-AS-KHEN-C7ANAF-20210928101727

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 567609936
Report Date: 07/16/2021
Date Signed: 07/16/2021 05:31:24 PM

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
07/13/2021 and conducted by Evaluator Joann Rosales

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20210713162338

FACILITY NAME:	OAKMONT OF RIVERPARK		FACILITY NUMBER:	567609936
ADMINISTRATOR:	LIBHART, JILL		FACILITY TYPE:	740
ADDRESS:	901 TOWN CENTER DRIVE		TELEPHONE:	(805) 940-0390
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	140	CENSUS: 81	DATE:	07/16/2021
		UNANNOUNCED	TIME BEGAN:	10:33 AM
MET WITH:	Glen McCall		TIME COMPLETED:	04:49 PM

ALLEGATION(S):

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Facility staff did not safeguard resident's personal property

INVESTIGATION FINDINGS:

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During today's visit Licensing Program Analyst (LPA) JoAnn Rosales toured the facility with the Administrator, reviewed resident records, obtained copies of pertinent documents and interviewed resident and staff.

Concerns were that facility staff did not safeguard resident #1 (R1)'s personal property as cash and jewelry valued at over 28,000.00 was missing from their locked file cabinet and locked wall jewelry cabinet. Interview with Administrator at 12:48 pm revealed that they were not at the facility when the police came on 6/30/21. Administrator stated that they spoke with R1 in passing on 7/6 or 7/7/21 who indicated that personal jewelry and money were taken from their apartment. Administrator stated that they have been interviewing staff regarding the incident and other recent incidents of alleged thefts for R2, R3 and R4. A review of the facilities theft and loss policy at 12:59 pm revealed that the facility will maintain a current inventory of all personal property identified by residents on licensing form LIC621. Upon admission the resident or responsible party will be provided with a blank LIC621. Loss of personal property with a value of $25.00 or more will be
Continued on 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Joann Rosales	TELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

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-20210713162338

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 RIVERPARK	FACILITY NUMBER: 567609936
	VISIT DATE: 07/16/2021

NARRATIVE

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documented within 72 hours. If the loss exceeds $100.00 a report will be filed with a Law Enforcement Agency within 36 hours. The loss will be documented on the Investigation report. The loss will be investigated as outlined in the Internal Investigation policies and Theft policies. Interview with R1 at approximately 1:19 pm revealed that about 20,000.00 worth of jewelry was taken from their apartment as well as $400.00 in cash on 6/29/21. R1 stated that they noticed that it was missing on 6/29/21 at approximately 8:30 pm. R1 stated that the file cabinet and the wall jewelry cabinet in their apartment were locked when they went out that day. R1 stated that they spoke with the Administrator on 6/30/21 notifying them about the stolen jewelry and money valued at least $20,000.00. R1 stated that when they moved into the facility they were never asked if they had any valuables nor were they offered a safe place to keep their valuables. Interview with staff #1 (S1) at 2:55 pm revealed that they were unable to locate a LIC621 for R1. S1 stated that an incident report was not submitted to CCL regarding R1's reported theft. S1 stated that they were not at the facility on 6/30/21 however, they were notified of the incident by staff via text message. Interview with Administrator at 4:06 pm revealed that they do not have a LIC 9060 Resident Theft and Loss form completed for the reported resident thefts.

Based on information obtained during the course of the investigation, it was determined that R1's missing items were not documented in the facility records. Therefore, there is sufficient evidence to support that the facility did not make a reasonable effort to safeguard the resident's property as all the requirements of H&S code 1569.163 were not met and the losses were not documented. Therefore, the allegation is deemed substantiated at this time.

Exit interview was conducted, today's report was reviewed and emailed to the Administrator.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Joann Rosales	TELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20210713162338

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 RIVERPARK	FACILITY NUMBER: 567609936
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/16/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/23/2021 Section Cited CCR 87218(2)	1 2 3 4 5 6 7	87218 Theft and Loss (2) A licensee who fails to make reasonable efforts to safeguard resident..... The licensee shall be presumed to have made reasonable efforts to safeguard resident property if there is clear and convincing evidence of efforts to meet each requirement specified in Section 1569.153. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator stated that they will submit a written plan of action stating how they will comply with regulation 87218 and send to CCL by 7/23/21.
	8 9 10 11 12 13 14	Based on interviews and record review, the licensee did not comply with the section cited above as the licensee did not ensure that R1's missing items were documented in the facility records which poses a potential personal rights risk to persons in care.	8 9 10 11 12 13 14
Type B 07/23/2021 Section Cited CCR 87211(a)(1)(D)	1 2 3 4 5 6 7	87211 Reporting Requirements (a)(1)(D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator stated that they will submit incident reports for theft incidents to CCL by 7/23/21.
	8 9 10 11 12 13 14	Based on interviews, the licensee did not comply with the section cited above as incident reports were not completed and submitted to CCL for theft incidents which poses a potential personal rights risk to persons in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Joann Rosales	TELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

LIC9099 (FAS) - (06/04)

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