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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610183
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:31:27 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/13/2023 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20230713112552
FACILITY NAME:OAKMONT OF VALENCIAFACILITY NUMBER:
197610183
ADMINISTRATOR:MYLA BELSONFACILITY TYPE:
740
ADDRESS:24070 COPPER HILL DRIVETELEPHONE:
(661) 568-6080
CITY:VALENCIASTATE: CAZIP CODE:
91354
CAPACITY:144CENSUS: 103DATE:
02/06/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Myla Belson TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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1. Staff did not ensure medication was dispensed as prescribed for resident in care
2. Staff did not ensure resident was properly positioned in bed, resulting in a fall
3. Staff do not ensure infection control policies are maintained
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit, to finish and deliver the final findings to the allegations mentioned above. LPA met with Executive Director Myla Belson and informed her the reason of the visit. The following was determined:

Allegation #1: It was alleged that staff did not ensure medication was dispensed as prescribed for a resident in care. To investigate the complaint, on 07/23/2023, 12/03/2024, and 02/06/2025, at various times between 9:45 a.m. and 3:30 p.m., (LPA) conducted interviews and reviewed relevant documents. According to documentation reviewed, Resident #1 (R1) was out of the facility and hospitalized from 06/11/2023 through 06/18/2023 before being discharged and returning to the facility on the same day. Upon R1's return, new medication orders were electronically submitted to the pharmacy. However, the pharmacy required clarification of the prescriptions and contacted R1's primary physician. The facility also reached out to R1’s primary doctor regarding the undelivered medication. The physician’s office clarified the
(see LIC9099C-cont'd)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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 2
Control Number 31-AS-20230713112552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF VALENCIA
FACILITY NUMBER: 197610183
VISIT DATE: 02/06/2025
NARRATIVE
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orders and resubmitted them to the pharmacy. The pharmacy did not receive the updated prescriptions until 06/25/2023, at which point the medication was processed, filled, and delivered to the facility. R1 started the new prescription on 06/25/2023. After reviewing R1’s hospital records, LPA determined that the facility contacted R1’s primary doctor as soon as they became aware that the medication had not been received. R1’s doctor’s office then contacted the pharmacy to verify the prescriptions, and the medication was delivered once the orders were clarified. Therefore, the facility administered the medication according to the doctor’s orders once it was received from the pharmacy. Based on the documentation reviewed, there is insufficient evidence to support the allegation. As a result, the allegation is Unsubstantiated at this time.

Allegation # 2: It was alleged that staff did not ensure a resident was properly positioned in bed, resulting in a fall. To investigate the complaint, on 07/23/2023, 12/03/2024, and 02/06/2025, at various times between 9:45 a.m. and 3:30 p.m., (LPA) conducted interviews and reviewed relevant documents. According to the information obtained, Resident #1 (R1) experienced a change in condition, prompting the facility to enroll R1 in its fall management program. LPA received an incident report documenting that R1 had fallen but sustained no injuries. Although it was reported that R1 may have been improperly positioned in bed, there is no evidence to substantiate the allegation. Therefore, based on the information gathered through interviews and document reviews, the allegation is Unsubstantiated at this time.

Allegation # 3: It was alleged staff do not ensure infection control policies are maintained. To investigate the complaint, on 07/23/2023, 12/03/2024, and today, 02/06/2025, from various timeframes, between 9:45 a.m. and 3:30 p.m., (LPA) conducted interviews and reviewed documents relevant to the allegation. According to the information obtained, there have been no recent reported cases of residents contracting shingles or exposing others to the infection within the facility. However, it was revealed that Resident #2 (R2) had shingles over a year ago but was quarantined and remained in isolation in their room. Staff reported that meals and medication were provided to R2 in the room to prevent exposure to others. Neither staff nor residents interviewed by LPA reported any instance of a resident walking around the facility with a serious infection. Therefore, based on the interviews conducted, there is insufficient evidence to support the allegation. As a result, the allegation is Unsubstantiated at this time.

Exit interview and copy of report provided.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC9099 (FAS) - (06/04)
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