092700572-5-18-2021-27-AS-MSEY-C37PLJ-20210520112450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 092700572
Report Date: 05/18/2021
Date Signed: 05/18/2021 03:18:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/19/2020 and conducted by Evaluator Michael Smith

COMPLAINT CONTROL NUMBER: 27-AS-20200219150747

FACILITY NAME:	OAKMONT OF EL DORADO HILLS		FACILITY NUMBER:	092700572
ADMINISTRATOR:	HEATHER YOUNAN		FACILITY TYPE:	740
ADDRESS:	2020 TOWN CENTER WEST WAY		TELEPHONE:	(916) 467-8330
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	0	CENSUS: 0	DATE:	05/18/2021
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Krystal Jenkins		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility staff failing to provide adequate food service

Facility staff not meeting residents bathing needs

Facility staff failing to meet resident's overall care needs

Facility staff failing to administer medication to resident as prescribed

INVESTIGATION FINDINGS:

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LPA Smith conducted an unannounced complaint visit and met with Krystal Jenkins.

Allegation: Facility staff failing to provide adequate food service
Resident routinely refuses the daily special but really likes mac n cheese and ham sandwiches. Tanya Jackson, MCD stated that the resident's weight loss is directly related to her end stage dementia and subsequently being placed on hospice. In order to have her eat, they specially prepared the mac n cheese and ham sandwiches since that is a food that she will eat. Additionally, she is encouraged to eat and staff will assist when needed. Responsible party also requested a change in diet to softer foods, bananas, applesauce, soup, scrambled eggs, etc. Resident is frail and due to recent weight loss, her dentures do not fit properly and it hurts her when she eats. MD ordered a puree diet. Hospice Notes- Puree diet, requires assistance with all ADLs, poor oral intake (food). Facility has, in conjunction with the responsible party, modified resident's diet in order to accommodate her dietary needs to foods that the resident likes and could eat without any major problems. Based on this, this allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Michael Smith	TELEPHONE: (916) 208-7807
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021

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 27-AS-20200219150747

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: OAKMONT OF EL DORADO HILLS	FACILITY NUMBER: 092700572
	VISIT DATE: 05/18/2021

NARRATIVE

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Facility staff not meeting residents bathing needs
Resident is unable to bear weight and is on hospice. Chart notes show weekly bathing and according to Tanya Jackson, MCD she is given a sponge bath daily. Hospice notes do not indicate any concerns regarding resident hygiene. Resident requires assistance for all bathing and notes indicate sponge baths. Based on this, this allegation is UNSUBSTANTIATED.

Facility staff failing to meet resident's overall care needs
Chart notes indicate that the resident's needs - bathing, grooming, denture care, dressing, eating, diet, toileting, escorting, transfers appear to be addressed and notated / documented by on duty staff. No indication in hospice notes that resident's needs are not being met. Based on this, this allegation is UNSUBSTANTIATED.

Facility staff failing to administer medication to resident as prescribed
MAR for February 2020 indicates that Rx medication is being prescribed as directed, OTC medication were periodically administered per resident's request and charted. Resident is able to communicate her needs. Based on this, this allegation is UNSUBSTANTIATED.

As a result of this investigation, LPA finds the allegation that facility staff failing to provide adequate food service, facility staff not meeting residents bathing needs, facility staff failing to meet resident's overall care needs and facility staff failing to administer medication to resident as prescribed to be UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Michael Smith	TELEPHONE: (916) 208-7807
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021

LIC9099 (FAS) - (06/04)

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