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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 092700750
Report Date: 02/24/2021
Date Signed: 02/24/2021 12:35:42 PM

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: 82DATE:
02/24/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Janelle ZweberTIME COMPLETED:
12:45 PM
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Case management visit regarding the review of the facility Disaster Plan - LIC 610E and the facility Disaster and Emergency Manual, approximately 250 pages. Facility reports that there are no cases of Covid 19 at this time. Upon review of the Disaster Plan LIC 610E and the facility Disaster and Emergency Manual the provided documents shows that the facility is in compliance set forth in Title 22, Section 87212 Emergency Disaster Plan.

Additionally, LPA observed staff member Aseem Sidhu, in the lobby area of the facility with a mask that was under his chin exposing both his nose and mouth, talking to other staff members.

See LIC 9102 Technical Violation.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Michael SmithTELEPHONE: (916) 206-7807
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021
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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