019201084-8-9-2024-15-AS-KHOS-D8HK93-20240826074139

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019201084
Report Date: 08/09/2024
Date Signed: 08/09/2024 02:43:01 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/01/2024 and conducted by Evaluator Gregory Clark

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20240801103608

FACILITY NAME:	OAKMONT OF MARINER POINT		FACILITY NUMBER:	019201084
ADMINISTRATOR:	HAN, MINDY M		FACILITY TYPE:	740
ADDRESS:	2400 MARINER SQUARE DRIVE		TELEPHONE:	(510) 347-5959
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94502
CAPACITY:	80	CENSUS: 49	DATE:	08/09/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Jannelle Douglas, Administrator		TIME COMPLETED:	02:55 PM

ALLEGATION(S):

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Staff left resident without care and supervision for an extended period of time.
Resident in care developed a wound due to lack of staff supervision.
Staff did not ensure that resident's hygiene needs were met while in care
Staff did not ensure that resident was fed while in care.
Staff did not follow personal hygiene and sanitation practices.

INVESTIGATION FINDINGS:

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On 8/09/24 at 11:00 a.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct an initial 10-day complaint investigation and deliver findings in regard to the allegations above. LPA met with Jannelle Douglas, Administrator and explained the purpose of the visit.

During the course of the investigation LPA attempted to reach the Reporting Party (RP) by phone and email. RP never contacted LPA.

LPA interviewed W1, R1’s son. W1 stated that the care R1 received at the facility was “exceptional.” W1 visited R1 on a daily basis and never observed any of the allegations cited in the complaint. W1 stated that the care R1 received at the facility was “the complete opposite” of what is stated in the complaint. W1 further stated that the “care and love” R1 received at the facility was “transformational” for R1.

***report continues on LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory Clark	TELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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 15-AS-20240801103608

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: OAKMONT OF MARINER POINT	FACILITY NUMBER: 019201084
	VISIT DATE: 08/09/2024

NARRATIVE

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***report continues from LIC9099***

At the facility LPA reviewed R1’s file and interviewed S1 and S2 and toured the memory care unit.

R1 was admitted to the facility on 3/23/2024, admitted to hospice on 4/08/24 and passed away on 7/23/24.

S1 stated that she never heard any complaints about R1’s care from R1’s Responsible Party. S1 did state that she heard that the RP was rude to the facility staff and was very disruptive during her visits to the Memory Care Unit where R1 resided.

S2 stated that R1 was monitored closely by the Memory Care Unit staff and was never left unsupervised for extended periods of time. R1 did develop several wounds while in care due to R1 being bed bound while also being very restless. The wounds were treated as prescribed and never developed past Stage 1. S2 further stated that R1’s was given bed bath’s 3 times weekly. LPA confirmed this by reading the care notes in R1's chart.

Allegation: Staff left resident without care and supervision for an extended period of time.

R1 was visited by W1 on a daily basis. W1 always observed that staff were attending to R1. R1 also had visits from Hospice 3 - 4 times a week and a Nurse twice weekly. Review of chart notes do not document any concerns about R1’s care and supervision. This allegation is unsubstantiated.

Allegation: Resident in care developed a wound due to lack of staff supervision.

R1 did develop wounds while in care. S2 stated that it is not uncommon for bed bound residents on hospice to develop these types of wounds. S2 further stated that R1’s wounds were not due to a lack of staff supervision but due to R1’s deteriorating condition. This allegation is unsubstantiated.

Allegation: Staff did not ensure that resident's hygiene needs were met while in care.

Review of R1’s chart and interview with S2 revealed that R1 was receiving assistance with his activities of daily living on a daily basis and receiving bed baths 3 times weekly. This allegation is unsubstantiated.

***report continues on LIC9099C***

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory Clark	TELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 15-AS-20240801103608

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: OAKMONT OF MARINER POINT	FACILITY NUMBER: 019201084
	VISIT DATE: 08/09/2024

NARRATIVE

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***report continues from LIC9099C***

Allegation: Staff did not ensure that resident was fed while in care.

Over the course of R1’s time at the facility (4 months) R1 went from being on a regular diet and able to feed himself independently to being placed on a puree diet where he needed staff assistance. S2 stated that R1 simply lost to desire to eat and that R1 always had a staff person assigned to him to assist during meals. This allegation is unsubstantiated.

Allegation: Staff did not follow personal hygiene and sanitation practices.

LPA toured Memory Care Unit and observed all staff wearing gloves and masks. Hand washing signs are posted by each sink. S2 stated that all staff receive training on personal hygiene and sanitation practices. LPA asked 2 memory care staff when they are required to wash their hands, both replied "all the time." This allegation is unsubstantiated.

This agency has investigated the complaint alleging staff left resident without care and supervision for an extended period of time, resident in care developed a wound due to lack of staff supervision, staff did not ensure that resident's hygiene needs were met while in care, staff did not ensure that resident was fed while in care and staff did not follow personal hygiene and sanitation practices. We have found that the complaint was unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted, a copy of this report provided.

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory Clark	TELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

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