019201084-9-17-2024-15-AS-YFLS-DBCVAT-20241125151628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019201084
Report Date: 09/17/2024
Date Signed: 09/17/2024 02:29:09 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
06/13/2024 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20240613164149

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: 51	DATE:	09/17/2024
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Jannelle Douglas, Administrator		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Staff dispense medication to residents without appropriate training.
Staff mismanage residents’ medications.
Staff do not provide adequate supervision for residents.

INVESTIGATION FINDINGS:

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On 9/17/24 at 2:15 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to 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 reviewed facility records and interviewed staff.

Allegation: Staff dispense medication to residents without appropriate training.

At the time of the complaint the facility had 5 med techs and 1 med tech in training. The LPA reviewed the training records for 5 med techs (S2, S3, S4, S5 and S6) all had proper medication training. S1 also dispenses medication as needed and review of S1’s file documented that S1 has the required training to pass medication. This allegation in unsubstantiated.

***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: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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 15-AS-20240613164149

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: 09/17/2024

NARRATIVE

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***report continues from LIC9099***

Staff mismanage residents’ medications.

LPA reviewed medication administration records (MARs) for R1, R2 and R3 and found no evidence that any of their medications were mismanaged. All 3 residents received their medications as prescribed and properly documented on the MAR. This allegation in unsubstantiated.

Staff do not provide adequate supervision for residents.

LPA interviewed S1 and S7 who are responsible to manage transportation for residents who need assistance in getting to their doctors’ appointment. Both stated that residents are either transported by family or in the facility van with staff accompanying them if needed. Both stated that no residents with dementia are ever put in an Uber to be transported by themselves to a doctors’ appointment. This allegation in unsubstantiated.

This agency has investigated the above allegations. We have found that the allegations were 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 allegations are 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: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC9099 (FAS) - (06/04)

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