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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850169
Report Date: 10/21/2025
Date Signed: 10/21/2025 02:42:48 PM

Substantiated


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
08/22/2025 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20250822191726
FACILITY NAME:OAKMONT OF CAMARILLOFACILITY NUMBER:
565850169
ADMINISTRATOR:FOERSCHNER, BRADLEEFACILITY TYPE:
740
ADDRESS:305 DAVENPORT STREETTELEPHONE:
(805) 738-3600
CITY:CAMARILLOSTATE: CAZIP CODE:
93012
CAPACITY:150CENSUS: 100DATE:
10/21/2025
UNANNOUNCEDTIME BEGAN:
10:16 AM
MET WITH:Mark CortesTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility staff are not adequately trained and have not received instructions from a professional to manage resident's colostomy bag
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Martha Arroyo and Brian Balisi conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegation. The initial complaint visit was conducted on 08/29/2025 by LPA M. Arroyo. On today's visit, LPAs met with Executive Director (ED) Mark Cortes. Entrance interview.

During the initial visit on 08/29/2025, between 09:32 a.m. and 11:30 a.m., LPA Arroyo conducted interviews with five staff and one resident, conducted a resident file review, and obtained copies of pertinent documents.

Report Continued on LIC 9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
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 3
Control Number 29-AS-20250822191726
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: 565850169
VISIT DATE: 10/21/2025
NARRATIVE
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Report Continued from LIC 9099...

It was alleged that facility staff are not adequately trained and have not received instructions from a professional to manage resident’s colostomy bag. It is the complainant’s concern that facility staff are draining resident’s colostomy bag daily; however, staff have not been trained by a licensed professional to properly drain the colostomy bag. During the visit on 08/29/2025, the LPA requested facility personnel records documenting staff training, including—but not limited to—training in colostomy care provided by a medical professional. However, no training records related to colostomy care were made available for review at that time. Further staff interviews revealed that caregivers had not received training from a medical professional prior to assisting the resident with draining their colostomy bag, and the facility did not have any training records on file related to colostomy care. On 09/12/2025, the LPA was provided with training records indicating that facility staff received colostomy care training from a medical professional on 08/29/2025 and 09/03/2025. However, this training occurred after staff had already been assisting resident with colostomy care. Based on the information obtained and reviewed during the course of the investigation, the Department has sufficient evidence to support the allegations of “facility staff are not adequately trained and have not received instructions from a professional to manage resident's colostomy bag”. Therefore, this allegation is deemed Substantiated at this time.

The following deficiencies were observed and cited from the California Code of Regulations, Title 22. (See LIC 809-D).

Exit interview was conducted. A copy of the report and appeal rights were provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20250822191726
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: 565850169
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/21/2025
Section Cited
CCR
87613(a)(2)
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Ensure that facility staff complete training provided by a licensed professional…training shall be completed prior to the staff providing services to the resident. This requirement was not met as evidenced by:
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Colostomy Care training was provided to facility staff by a skilled professional on 08/29/2025 and 09/03/2025. Training records provided to LPA on 09/12/2025.
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Based on record review and interviews, the licensee did not comply with the section cited above as staff was assisting resident with colostomy care prior to getting training by a skilled professional, which poses a potential health and safety risk to persons in care.
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POC has been met.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3