092700750-3-4-2022-25-AS-KHOS-CCLK7U-20220317073944

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 092700750
Report Date: 03/04/2022
Date Signed: 03/04/2022 02:27:18 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
01/19/2022 and conducted by Evaluator Michael Hood

COMPLAINT CONTROL NUMBER: 25-AS-20220119142247

FACILITY NAME:	OAKMONT OF EL DORADO HILLS		FACILITY NUMBER:	092700750
ADMINISTRATOR:	STEPHEN W MACDONALD		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: 89	DATE:	03/04/2022
		UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Stephen W MacDonald, Administrator		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Facility staff not allowing family member visitation.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Executive Director, Stephen W MacDonald, to deliver findings into the complaint allegation listed above. Facility currently does not have any COVID-19 positive cases. LPA wore N-95 mask and was screened by facility upon entry. Facility staff wore masks at the facility.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

Allegation: Facility staff not allowing family member visitation

** Report continued on 9099-C **

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael Hood	TELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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 25-AS-20220119142247

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: 092700750
	VISIT DATE: 03/04/2022

NARRATIVE

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In PIN 22-04-ASC, issued 1/18/2022 and with an effect date of 1/7/2022 , the department instructed Licensees to “allow indoor visitation, including communal dining and in-room visitation, at all times and for all residents regardless of vaccination status of the resident, if (1) the visitor is fully vaccinated, have had all recommended booster doses based on the table below and provide evidence of a negative COVID-19 test within one day of visitation for antigen tests, and within two days of visitation for Polymerase Chain Reaction (PCR) tests; OR (2) permit only outdoor visitation for those that do not meet all the aforementioned requirements in this section. Staff must screen visitors and the visitor must be asymptomatic, and staff should clean and disinfect surfaces.” The PIN also states “If there are differing requirements between the most current CDC, CDPH, CDSS, CDDS, Cal/OSHA, and local health department guidance or health orders, licensees should follow the strictest requirements.”

On 1/21/2022, LPA contacted Public Health Nurse (PHN) from El Dorado County Public Health to inquire whether Local County Public Health instructed facility to close off in-room visitation to portions of the facility due to COVID-19 outbreak. PHN informed CCLD that facility was instructed by El Dorado County Public Health that facility may “close down visitation” until facility and Local County Public Health had a better understanding of how much the COVID-19 outbreak had spread inside of the facility.

With the information above, the facility was following the strictest guidelines set forth by the Local County Public Health and, therefore, the facility restricting visitation in portions of the facility was approved by CCLD.

Based on interviews conducted by LPA and records reviewed, the above allegation is found to be 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 was conducted with Executive Director and a copy of this report was provided to the facility. The signature of the Executive Director on these forms acknowledges receipt of these documents.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael Hood	TELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

LIC9099 (FAS) - (06/04)

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