306005740-5-14-2026-22-AS-APAO-DU965V-20260519203058

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005740
Report Date: 05/14/2026
Date Signed: 05/14/2026 04:00:58 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/26/2024 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20241126135236

FACILITY NAME:	OAKMONT OF ORANGE		FACILITY NUMBER:	306005740
ADMINISTRATOR:	ANNA PASTORES		FACILITY TYPE:	740
ADDRESS:	630 THE CITY DRIVE SOUTH		TELEPHONE:	(714) 880-8624
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY:	155	CENSUS: 93	DATE:	05/14/2026
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Dennis Robeniol		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff did not seek timely medical care for resident in care

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez for the purpose of delivering findings. LPA met with Executive Director (ED) Dennis Robeniol and explained the purpose of the inspection.

Complaint alleges Staff did not seek timely medical care for Resident 1 (R1).

During the course of the investigation, LPA obtained a copy of Charting Notes indicated that on November 26, 2024 at approximately 12 p.m., R1 had reported pain to left hip and leg and was unable to bare any weight on their left leg. An ambulance was called and arrived at approximately 12:15 p.m. to transport R1 to the hospital. Interviews were conducted with one witness and eight facility residents, including R1. During their interview, R1 was unable to confirm or deny the allegation. During their interview, R1’s responsible party, Witness 1 (W1), stated that on the morning of November 26, 2024, they received a call from a staff member who informed them R1 had fallen. (Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026

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 22-AS-20241126135236

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: OAKMONT OF ORANGE	FACILITY NUMBER: 306005740
	VISIT DATE: 05/14/2026

NARRATIVE

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W1 was unable to recall the exact time of the phone call or the events leading up to R1’s fall and could not recall which staff member had called to inform them of the fall. W1 stated that during the call they were informed no injuries or pain had been reported by R1 and no injuries had been observed by staff. Per W1, they later received a second call on the same date indicating R1 was experiencing pain and was being transferred to the hospital. W1 denied staff not seeking timely medical care as R1 had not initially reported any pain and staff had not observed any injuries. W1 stated they did not have any concerns regarding the care provided by the facility. During their interview, seven of seven residents denied having any knowledge of staff not seeking or delaying medical care for residents.

Based on record review of R1's Charting Notes and due to allegation being uncorroborated during interviews conducted, the Department is unable to determine if Staff did not seek timely medical care for resident in care. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026

LIC9099 (FAS) - (06/04)

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