Oakmont of Valencia.

Licensing Program Analyst (LPA) , Angela Panushkina , arrived on June 11, 2026, for an unannounced inspection to follow up on a substantiated allegation of resident sustained an unexplained injury in care, resident sustained multiple falls due to lack of supervision and facility is not meeting residents’ nighttime supervision needs. LPA met with the Administrator, Assaad Zeid, and explained the reason for the visit. On March 29, 2023, the Department concluded a complaint investigation regarding the following allegations: Resident sustained an unexplained injury in care, Resident sustained multiple falls due to lack of supervision, and facility is not meeting resident's nighttime supervision needs. The licensee was cited for California Code of Regulations (CCR) Title 22, Section 87705(c)(5)(A) Care of Persons with Dementia and CCR Title 22, Section 87705(4) Care of Persons with Dementia. At the time of the complaint visit on March 29, 2023, an immediate civil penalty of $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code §1569.49(f). The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section 15610.67 defines serious bodily injury as “an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to, hospitalization, surgery, or physical rehabilitation.” This is evidenced by the facility not providing proper care and supervision that resulted in multiple fractures from multiple falls. Continue on LIC809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Today, June 11, 2026, the Department will be issuing a civil penalty per Health and Safety Code §1569.49(f) for a violation that the Department determines constitutes as serious bodily injury in the amount of $10,000. However, since an immediate civil penalty of $500 was previously issued on March 29, 2023, the amount of the civil penalty issued today will be $9,500. Exit interview conducted. A copy of the report issued. Appeal rights provided. The Administrator, Assaad Zeid, and signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.

It was alleged that the facility failed to provide both verbal and written medical information from R1’s primary care physician to the authorized representative. However, based on a review of the legal documentation, including the POA, as well as information obtained through interviews, LPA determined that the facility is acting in accordance with the authority and limitations outlined in the POA. Based on the evidence obtained, and interviews, the allegation is deemed Unsubstantiated.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted a case management regarding an incident report that was received, involving a contracted physical therapist, working for an agency hired by the facility, allegedly exposed private parts to resident # 1 (R1). During the visit, LPA obtained resident records and interviewed staff. At this time, LPA will follow up with additional interviews and obtain police report documentation. Further review is required and LPA will return at a later date and time to gather more information. Also during the visit, LPA obtained documentation involving an alleged resident # 2 (R2) eloping from the facility and the incident was not reported to Licensing. LPA conducted interviews and at this time additional information is required to complete the investigation of failure to report. Exit interview and copy of report provided to the ED.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an annual continuation inspection. LPA met with Executive Director Myla Belson and informed her the reason of the visit. During today's visit, from 930am to 230pm, LPA conducted audit review of staff and resident records. For residents, LPA inspected (10) resident files out of (103) residents. Residents records had current physician reports, and needs and service plans. Staff records, LPA reviewed (10) staff files: training records were current and up to date, first aid/CPR certificates were valid, and all staff had criminal record clearances. To complete the annual, LPA will return to audit medication records and resident's medication. Annual inspection is not completed at this time. Exit interview and copy of report provided to ED.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an Annual Required visit and inspection of the facility. LPA met with an Executive Director and Myla Belson and explained the reason for the visit. The facility is a large 2 story building with two (2) Memory Care Units (Tradition 1 and Tradition 2). In the main entrance of the building there is a cafe that is a self-serving refreshment and snack area with seating. The main living room has seating and a grand piano for entertainment. There is a reading room and private dining area for family or visitors to use. Smoke detectors/carbon monoxide are hardwired and located throughout the facility. Fire alarms are program to dispatch the Fire Department. Fire extinguishers are located throughout the facility. . Common Areas: Common areas consists of front lobby sitting area, activity rooms, in Assistance Living, and Memory Care Units. All areas are properly furnished, with sufficient room for residents to lounge. Facility also has a beauty salon, gym and a theater for residents. Laundry area is located on a the first and second floor of the facility. Facility has three (3) med-tech rooms, two (2) are located inside the Memory Care Unit and one (1) room is on an Assisted Living side. During today's visit, LPA started reviewing resident files. Due to time constraints, today's annual was not able to be completed. LPA will return at another date and time to continue additional review of resident, and staff files. Also, LPA will continue the physical plant inspection of the facility, which includes residents rooms, common area and kitchen. . Exit interview conducted and copy of report provided to Administrator. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 During today's visit, LPA started reviewing resident files. Due to time constraints, today's annual was not able to be completed. LPA will return at another date and time to continue additional review of resident, and staff files. Also, LPA will continue the physical plant inspection of the facility, which includes residents rooms, common area and kitchen. . Exit interview conducted and copy of report provided to Administrator.

Based on interviews, there is insufficient evidence to support the allegation, therefore it's deemed Unsubstantiated at this time. Exit interview conducted and copy of report provided to ED.

To resolve the matter, the ED, along with corporate representatives, offered R1 a monetary gift card so that R1 could replace the missing items. The gift card was accepted. Interviews with other residents indicated they had not experienced missing items and would report it to staff if that occurred. Although some of R1’s belongings were reported missing, evidence suggests R1 often misplaced items throughout the facility, and some were later recovered. In good faith, the ED provided a gift card for replacement of items. Based on the information obtained and interviews conducted, there is insufficient evidence to substantiate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Exit interview conducted and copy of report provided to the ED.

and modifying care practices. An overnight care companion, and frequent routine wellness checks were conducted during the day to monitor R1. Therefore, based on interviews and documentation reviewed, there is insufficient evidence to support the allegation. The allegation is determined to be Unsubstantiated at this time. Allegation # 2: It was alleged resident sustained injuries while in care. To investigate the allegation, on June 24, 2024, and during today’s visit, (LPA) conducted interviews and reviewed relevant documentation pertaining to the allegation. Based on the information obtained, Resident #1 (R1) was assessed upon admission and was noted to have pre-existing bruising and wounds. R1 was also identified as a fall risk. According to interviews, R1’s family reported that R1 had a history of falls while living at home prior to admission. After being admitted to the facility, R1 continued to experience multiple falls, resulting in bruising and injuries. Facility staff provided first aid, notified R1’s family and primary care physician, and ensured R1 received medical attention from healthcare professionals. Documentation confirmed that staff recorded the incidents in internal charting notes and submitted Special Incident Reports (SIRs) to Community Care Licensing (CCL). Although it was reported that R1 sustained injuries while in care, the facility responded appropriately by providing timely treatment, notifying responsible parties, and seeking necessary medical evaluation. Therefore, based on the interviews and documentation reviewed, there is insufficient evidence to prove the allegation, and it is Unsubstantiated at this time.

LPA Tuesday Cabiness conducted a case management visit to follow up on two Special Incident Reports (SIRs) submitted by the facility. The incidents involved (1) a medication administration error, and an un- witnessed altercation between two residents that resulted in minor injuries and police involvement. Incident #1: Medication Error According to the SIR and interview with the Executive Director (ED), Resident #1 (R1) was recently prescribed a new medication, intended to be administered three times per week per the pharmacy label and the physician's written order. However, the pharmacy inputs physician orders for residents in a QMAR system that is able to be be read by the facility, that has description and details on RX's written by the primary physician. According to the QMAR, (R1) was to be administered the new RX once a day. But the RX label wrote (R1) was to be administered the RX, (3x) a week. The error occurred over four days, starting on April 2, 2025. During this period, R1 received the medication daily rather than as prescribed. Staff did not consult the on-duty nurse or verify the dosage instructions with the pharmacy. Once the error was identified, staff immediately informed the Executive Director and the Regional Health Services Director. R1 displayed no adverse reactions but was sent to the hospital for evaluation as a precaution. R1 returned the same day with no new orders. The primary physician and R1’s family were notified of the incident. In response, all medication technicians received credentialed training from the Allen Flores Group on April 8 and 9, 2025. Incident #2: Resident Altercation 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The second incident involved an un-witnessed altercation between Resident #1 (R1) and Resident #2 (R2). A staff member reported finding both residents on the floor in R2’s room, with each sustaining minor injuries. One resident had a head injury and was transported to the hospital for evaluation. The resident returned to the facility the same day with no new orders. The police were contacted in response to the incident. According to the ED, this was an isolated event between the two residents. There were no witnesses to the altercation, and the facility has taken measures to monitor both residents more closely. LPA will consult with the Regional Office (RO) and facility management regarding the medication error to determine if further action is warranted. At this time, additional review is required. Citation issued, civil penalty issued for repeated violation, appeal rights and copy of report provided to ED.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit to continue the annual inspection. During today's visit, LPA started to review (11) client files and (11) staff records. Medication review and the continuing of resident records will be completed at another date and time. Exit interview and copy of report provided.

R1’s condition daily and maintained constant communication with the family and primary care physician. Therefore, based on interviews and documentation, the allegation is Unsubstantiated at this time. Exit interview and copy of report provided.

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.

Based on interviews, observations, and records reviewed, there is insufficient evidence to support the allegation. Therefore, the allegation is determined to be Unsubstantiated at this time. Allegation # 2: Staff do not ensure residents are served food of good quality. To investigate this allegation, on July 23, 2023, from 10:45 a.m. to 11:45 a.m., (LPA) conducted staff interviews and reviewed documents relevant to the complaint. On December 3, 2024, during a follow-up visit from 10:00 a.m. 4:00 p.m., LPA conducted additional interviews with residents and staff, reviewed resident records, and performed a physical plant inspection. Information gathered through interviews, and a review of the facility’s daily menu, and observations of food served during the visit indicated that the facility provides residents with fresh, quality hot and cold food daily. The resident menu displayed a variety of meal options, with additional choices available. Residents interviewed stated that the food quality is overall good and that they can provide input and suggestions to the chef during monthly Town Hall meetings. Therefore, based on the evidence collected during interviews, and observations, the allegation is Unsubstantiated at this time . Allegation # 3: S taff do not ensure residents are provided with bathing assistance in a timely manner. To investigate this allegation, on July 23, 2023, from 10:45 a.m. to 11:45 a.m., (LPA) conducted staff interviews and reviewed documents relevant to the complaint. On December 3, 2024, during a follow-up visit from 10:00 a.m. to 4:00 p.m., the LPA conducted additional interviews with residents and staff and reviewed resident records. Information obtained during the investigation revealed that Resident #1 (R1) required assistance with showering and dressing. Interviews indicated that (R1) needed the support of two people for these tasks. Additionally, (R1) had a private caregiver who worked (8) to (12) hours daily and frequently assisted facility staff with (R1's) care. The facility maintains a shower schedule, and residents interviewed stated that staff provide assistance as needed. Other residents, who were independent, reported that staff are available when called for help. Based on interviews and documentation reviewed, there is insufficient evidence to prove the allegation, Therefore, the allegation is Unsubstantiated at this time. Exit interview and copy of report provided.

Based on interviews and documentation reviewed, there is insufficient evidence to prove the allegation, therefore, it is Unsubstantiated at this time. Allegation # 2: It was alleged staff failed to seek medical attention for resident in a timely manner. On 03/29/2023, from 10:30 a.m. to 2:40 p.m., (LPA) conducted the initial investigation, which included interviews, a review of facility and resident records, and a physical plant inspection. During a follow-up visit conducted today from 10:00 a.m. to 4:30 p.m., the LPA conducted additional interviews and reviewed resident records. On 03/09/2023, staff discovered( R1) on the bathroom floor following a fall. Staff observed a skin tear near (R1’s) elbow and applied first aid. Staff reported that (R1) did not complain of pain and displayed a full range of motion in both arms and legs. Documentation reviewed by LPA indicated that staff appropriately treated (R1’s) injury and continued to treat and monitor over several days. Documentation also demonstrated that the wounds appeared to be old and healing. Based on documentation and interviews, there is insufficient evidence to support the allegation that staff failed to seek timely medical attention. Therefore, the allegation is Unsubstantiated at this time. Allegation # 3: It was alleged staff left resident unattended for extended periods of time. On 03/29/2023, from 10:30 a.m. to 2:40 p.m., (LPA) conducted the initial visit, which included interviews, a review of facility and resident records, and a physical plant inspection. During a follow-up visit conducted today from 10:00 a.m. to 2:30 p.m., LPA conducted additional interviews and reviewed facility records. Staff and residents both denied staff leave them unattended for extended periods of time. And LPA does not have enough evidence to prove the allegation, therefore based on interviews, the allegation is Unsubstantiated at this time. Allegation # 4: It was alleged staff failed to meet reporting requirements. On 03/29/2023, from 10:30 a.m. to 2:40 p.m., the Licensing Program Analyst (LPA) conducted the initial visit, which included interviews, a review of facility and resident records, and a physical plant inspection. During a follow-up visit conducted today from 10:00 a.m. to 4:30 p.m., the LPA conducted additional interviews and reviewed facility records. It was reported that the facility was not submitting incident reports to the Department’s Complaint Intake Unit. LPA determined that the facility is submitting incident reports to the appropriate local regional office via fax or email. A review of the facility’s profile confirmed that incident reports are being submitted in a timely manner 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Based on record review, there is insufficient evidence to support the allegation that staff failed to meet reporting requirements. Therefore, the allegation is Unsubstantiated at this time. Allegation #5: It was alleged that staff failed to protect a resident from being harmed by another resident. On 03/29/2023, from 10:30 a.m. to 2:40 p.m., (LPA) conducted the initial visit, which included interviews, a review of facility and resident records, and a physical plant inspection. During a follow-up visit conducted today from 10:00 a.m. to 4:30 p.m., LPA conducted additional interviews and reviewed facility records. According to the information obtained, (R2) denied pushing (R1), while (R1) was vague about the alleged incident and denied it occurred. There were no witnesses that were identified by (LPA) and staff to confirm the incident. Both (R1) and (R2) are no longer residing at the facility. (R1) was relocated to another facility, and (R2) passed away. Based on interviews and documents reviewed, there is insufficient evidence to support the allegation, therefore it is Unsubstantiated at this time. Exit interview and copy of report provided to ED.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted an Annual Required visit and inspection of the facility. LPA met with an Executive Director and Myla Belson and explained the reason for the visit. LPA toured the facility and observed the following: The facility is a large 2 story building with two (2) Memory Care Units (Tradition 1 and Tradition 2). In the main entrance of the building there is a cafe that is a self-serving refreshment and snack area with seating. The main living room has seating and a grand piano for entertainment. There is a reading room and private dining area for family or visitors to use. Food Inspection: Kitchen and dining area are located on the ground floor of the facility. LPA observed there was sufficient stock of one week non-perishable foods and two days perishable food. Kitchen was observed to be sanitary and free of pests. And emergency food supply was stocked and locked in a storage room. Smoke detectors/carbon monoxide are hardwired and located throughout the facility. Fire alarms are program to dispatch the Fire Department. During the inspection, the building and fire inspectors were at the facility, conducting service, and checking the operation of alarms. Fire extinguishers are located throughout the facility, and were charged. Evacuation drills are conducted twice a year, and the fire drill/disaster are done once a month on every shift. Common Areas: Common areas consists of front lobby sitting area, activity rooms, in Assistance Living, and Memory Care Units. All areas were properly furnished and sanitary with sufficient room for residents to lounge. Facility also has a beauty salon, gym and a theater for residents. Laundry area is located on a the first and second floor of the facility. Facility has three (3) med-tech rooms, two (2) are located inside the Memory Care Unit and one (1) room is on an Assisted Living side. LPA observed all rooms were kept locked and inaccessible to residents in care. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Resident Rooms: Rooms consists of single or shared occupancy. A random selection of bedrooms was toured both in Memory Care and Assisted Living. All bedrooms were properly furnished and had appropriate furnishing. Rooms were observed to be sanitary. Bathrooms : Bathrooms were toured and observed to be clean. Nonskid mats and grab bars were observed in all bathrooms. Hot water was measured and was in compliance according to licensing requirements. There is an emergency pull cord located by the toilet. Due to time constraints, LPA was not able to complete the annual inspection. LPA will return to complete a full inspection and audit of resident, staff, and medication records. Exit interview and copy of report provided.

Licensing Program Analyst (LPA) Tuesday Cabiness conducted a Case Management, in conjunction with complaint control # (31-AS-20240618151354). According to information obtained during the preliminary of the investigation, it was reported that resident #1 (R1) had sustained multiple falls at the facility. LPA reviewed incident reports submitted by the facility, and LPA observed that one SIR (special incident report) was submitted pertaining to R1 falling on 06/17/2024. It was revealed to LPA that R1 fell twice, either once on 06/16/2024 or twice on 06/17/2024. The initial SIR reported, R1 fell once on 06/17/2024. Therefore, based on documentation and interviews, the facility failed to report R1 falling twice. This is a potential health and safety risk to residents in care. Citation issued and incident submitted to LPA during visit. POC cleared. Exit interview, citation, appeals, and copy of report provided.

Although the facility did not have hot water in various resident rooms, the ED contacted a plumbing company and the issue was resolved, and there were vacant rooms for residents to use for hot water use. Also, the entire facility was not impacted of not having hot water. Therefore, based on documentation and interviews, the allegation is Unsubstantiated . Allegation # 2: It was alleged residents’ incontinence needs were not met . On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. It was reported, the facility did have plumbing issues, and certain resident’s rooms water temperature was low. Although there were various resident’s rooms that had no hot water, the facility notified all the proper representatives and family and utilized vacant rooms for residents to use, therefore resident’s incontinent care needs was provided for. Based on documentation, the allegation is deemed Unsubstantiated at this time. Allegation #3: It was alleged residents’ bathing needs are not being met. On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. It was reported, the facility did have plumbing issues, and certain resident’s rooms water temperature was low. Although there were various resident’s rooms that had no hot water, the facility notified all the proper representatives and family and utilized vacant rooms for residents to use, so personal hygiene, such as showering, bathing and toileting were met. Therefore, based on documentation, the allegation is deemed Unsubstantiated at this time. Allegation # 4: It was alleged facility did not make sure elevator was working condition . On 01/19/2024, (LPAs) Gary Tan and Michael Cava conducted a physical plant inspection, interviewed staff, and obtained documents pertaining to the complaint. During today’s visit, from 1030am to 2pm, LPA Tuesday Cabiness conducted additional interviews, and reviewed documents pertaining to the allegation. According to information obtained, during the visit with (LPAs) Tan and Cava, it was reported that to them by the ED Myla Belson, that one of the wires got caught which caused the elevator to stop operating. Staff were instructed to stay at the stairwell for the residents that needed assistance coming up or downstairs. Although it was reported facility did not ensure the elevator was working, the ED contacted an elevator company, and the issue was resolved within a couple of hours. Facility took proper safety measures for the residents, therefore at this time, the allegation is deemed Unsubstantiated. Exit interview and copy of report provided.

At 10:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted a Case Management visit to Amend the following reports: Complaint Control #31-AS-20230608081726 , visit date conducted on 06/15/23 Case Management Incident visit date conducted on 06/15/23 Exit interview conducted and copy of this report signed and delivered

medications for one resident at a time. All MedTech’s informed LPA that once resident takes the medication, MedTech initials the Medication Administration Record (MAR) log. LPA was also informed that when the resident refuses to take the medication the staff member writes a comment/reason in MAR log as to why the medication was not taken. Based on review of the facility medication records for the months of September, October and November 2022, for three (3) out of three (3) residents, all documents appeared to be completed to its entirety including medication name, strength, instruction control, date filled, etc. Based on the interviews conducted and documentation reviewed, there is not enough substantial evidence or witnesses to concur with the allegations. Therefore, this allegation is deemed Unsubstantiated at this time. No deficiency cited during todays visit. Exit interview conducted and copy of this report provided to the Executive Director.