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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 092700750
Report Date: 08/10/2020
Date Signed: 08/10/2020 10:47:00 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:OAKMONT OF EL DORADO HILLSFACILITY NUMBER:
092700750
ADMINISTRATOR:YOUNAN, HEATHERFACILITY TYPE:
740
ADDRESS:2020 TOWN CENTER WEST WAYTELEPHONE:
(916) 467-8330
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:129CENSUS: 88DATE:
08/10/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Tamara FernandezTIME COMPLETED:
11:00 AM
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Pre-licensing visit conducted today by Michael Smith LPA and administrator Tamara Fernandez. There are 88 residents. Facility was granted fire clearance on 7/14/20 for a total of 129 residents, in which, 121 can be non -ambulatory and 8 bedridden seniors. Facility is approved for delayed egress. Facility will serve 129 senior residents ages 60 and over. Facility has numerous hand sanitizing stations and all staff were observed wearing masks.

Facility was inspected both indoors and outdoors. Outdoors was clean, tidy with adequate shading. Indoors has the requisite rooms for activity/den/dining. There are locked cabinets for personnel and client records. Facility has a First Aid kit and centrally stored locked cabinets for medication. Facility has appropriate linens for the bedrooms and baths. Bedrooms have the appropriate furnishings, chair, adequate lighting and storage. Water faucets are marked hot and cold. Smoke detectors were present. Fire extinguishers indicator revealed a full charge. Toxins and chemicals are appropriately locked in a cabinet. Kitchen was fully stocked with food. No hazardous debris noted.

All adults ages 18+ who reside here and are not clients, and all staff shall be fingerprinted and pass a criminal background check, prior to being present at the facility.

Licensee completed Component II on 5/7/20 and Component III is being waived at this time, as the company has several other facilities that are in good standing.

This report will be forwarded to the centralized application unit for continued processing.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Michael SmithTELEPHONE: (916) 206-7807
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2020
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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