092700750-10-19-2020-27-AS-KHOS-BV3SJU-20201105125544

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 092700750
Report Date: 10/19/2020
Date Signed: 10/19/2020 12:49:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/17/2020 and conducted by Evaluator Bethany Huusfeldt

COMPLAINT CONTROL NUMBER: 27-AS-20200917160940

FACILITY NAME:	OAKMONT OF EL DORADO HILLS		FACILITY NUMBER:	092700750
ADMINISTRATOR:	YOUNAN, HEATHER		FACILITY TYPE:	740
ADDRESS:	2020 TOWN CENTER WEST WAY		TELEPHONE:	(916) 467-8330
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	129	CENSUS: 92	DATE:	10/19/2020
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Heather Younan, Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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illegal eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Huusfeldt spoke with Administrator Heather Younan concerning complaint findings. Due to COVID-19 precautions, LPA was unable to meet in person with licensee.
LPA investigated the allegation of “Illegal eviction”. LPA reviewed residents’ documents and staff training and conducted interviews with staff, resident, and witness. An eviction letter was given to R1 from facility due to change in R1’s care needs. LPA observed a new assessment for R1 that was completed on 8/26/20, pre-admission assessment on 10/2/2019, and R1’s LIC602. Through record review LPA observed R1 care needs increased from time of admission to current assessment. LPA interviewed R1 in which they stated they did have a change in their level of care in May 2020. During this time resident required more assistance from staff and utilized a hoyer lift.
Continuation on 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Huusfeldt	TELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2020

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-20200917160940

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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 HILLS	FACILITY NUMBER: 092700750
	VISIT DATE: 10/19/2020

NARRATIVE

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Staff received training in May 2020 in regards to the use of the hoyer lift and transferring R1. LPA interviewed the Health Service Director(HSD) in which they stated R1 care needs changed significantly since admission, and they referred R1 to physical therapy and wound care and obtained medical equipment for R1. HSD stated R1 would sometimes require up to 3 caregivers in order to transfer, and caregivers were reporting injury due to transferring. Additionally LPA reviewed eviction letter and found required wording within eviction letter. Due to the information gathered LPA finds allegation to be unfounded.

Due to the information gathered LPA finds allegation to be UNFOUNDED. The allegation is UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Huusfeldt	TELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2020

LIC9099 (FAS) - (06/04)

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