<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
092700750
Report Date:
12/17/2021
Date Signed:
12/17/2021 11:48:41 AM
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
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
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:
90
DATE:
12/17/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
11:00 AM
MET WITH:
Stephen MacDonald
TIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Case management visit to review documents from a previous complaint. LPA received admission agreement documents, unusual incident reports and LIC 9060s. Copies were reviewed and retained.
SUPERVISOR'S NAME:
Laura Munoz
TELEPHONE:
(916) 263-4743
LICENSING EVALUATOR NAME:
Michael Smith
TELEPHONE:
(916) 208-7807
LICENSING EVALUATOR SIGNATURE:
DATE:
12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1