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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201084
Report Date: 09/23/2022
Date Signed: 10/19/2022 01:04:38 PM

Unfounded


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
09/16/2022 and conducted by Evaluator Gregory Clark
COMPLAINT CONTROL NUMBER: 15-AS-20220916141353
FACILITY NAME:OAKMONT OF MARINER POINTFACILITY NUMBER:
019201084
ADMINISTRATOR:HENRY, CAYIA A.FACILITY TYPE:
740
ADDRESS:2400 MARINER SQUARE DRIVETELEPHONE:
(510) 347-5959
CITY:ALAMEDASTATE: CAZIP CODE:
94502
CAPACITY:80CENSUS: 58DATE:
09/23/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cayia Peevy, Executive DirectorTIME COMPLETED:
12:25 PM
ALLEGATION(S):
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Facility did not safeguard resident's credit card
INVESTIGATION FINDINGS:
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***Amended Report***On 10/19/22 at 1:00 p..m. Licensing Program Analyst (LPA) Greg Clark conducted an unannounced visit to deliver an amended report in regards to the allegation above. LPA met with Executive Director Cayia Peevy and explained the purpose of the visit.

During the course of investigation, LPA interviewed Executive Director(ED) and client #1 (C1).

ED reported that at the request of C1's cousin the facility now keeps C1's credit card locked in a safe. C1 has a 1:1 aid 3 times a week who assists C1 on her shopping trips to ensure the credit card is accounted for and is used properly.

***amended report continues on LIC9099C***

Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory ClarkTELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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 2
Control Number 15-AS-20220916141353
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: 09/23/2022
NARRATIVE
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**amended report continues from LIC9099***

ED further reported that is unusual for the facility to hold personal possessions of their residents but did so this time at the request of the family.

At 11:50 a.m. on 9/23/22 LPA interviewed C1 in her apartment at the facility. C1 reported that she is fine with the facility holding her card. She also stated that she wasn't sure what happened around the alleged fraudulent use of the card calling it a "mix up." C1 also stated that the credit card was in her possession at the time of the alleged unauthorized use of the card. At no time did the facility have possession of the credit card. The charge at the Target store is not linked to the facility. The bank that issued the card has removed the charge from the account, closed the account and issued a new card.

This agency has investigated the complaint alleging that the facility did not safeguard resident's credit card. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.


Exit interview conducted, a copy of this reported and appeal rights provided.


SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory ClarkTELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2