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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201085
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:38:46 PM

Document Has Been Signed on 01/16/2025 12:38 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:OAKMONT OF CONCORDFACILITY NUMBER:
079201085
ADMINISTRATOR/
DIRECTOR:		SOR, KIM SFACILITY TYPE:
740
ADDRESS:1401 CIVIC COURTTELEPHONE:
(925) 798-4004
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY: 121CENSUS: 89DATE:
01/16/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Kim Sor, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On 1/16/25, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management visit due to receiving a LIC624 regarding an incident that occurred on 12/31/24 when a staff (S1) member working in the memory care unit yelling at resident's (R1). LPA met with Kim Sor, Executive Director and explained the purpose of the visit.

LPA interviewed S2 regarding the incident that occurred on 12/31/24. S2 stated S1's employment with the facility suspended on 12/31/2024 and then formally terminated on 1/5/25. Facility staff conducted a full investigation into the incident. S2 is deemed ineligible for re-hire. S2 admitted that S1 did yelled at the R1 and witness from other staff.

S1 is no longer at the facility. R1 was evaluated after the incident and appeared to not have been adversely affected by the incident. S2 also stated that S1 was immediately suspended at the time of the incident and later terminated.

Facility conducted a training on Elder Abuse Reporting on 12/25/24 and on 12/30/24 conducted a training on Residents Right Managing Aggressive Behavior as a reminder for staff to treat the residents with respect.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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