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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209036
Report Date: 12/12/2023
Date Signed: 12/12/2023 03:10:10 PM


Document Has Been Signed on 12/12/2023 03:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:OAKMONT OF NORTH FRESNOFACILITY NUMBER:
107209036
ADMINISTRATOR:SETTY, HEIDIFACILITY TYPE:
740
ADDRESS:5605 N GATES AVETELEPHONE:
(559) 277-5959
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:122CENSUS: 76DATE:
12/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Heidi SettyTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct a Case Management visit in conjunction with a complaint (Control Number 24-AS-20230809115225). LPA explained the purpose of the Case Management with Administrator (AD) Heidi Setty.

During an interview related to the complaint mentioned above, additional concerns were reported to LPA regarding Resident (R1).

LPA conducted additional interviews and record review during this visit.

There were no citations issued




An exit interview was conducted and a copy of this report was emailed to AD who signed the reports.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Katie BrownTELEPHONE: (559) 498-9964
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2023
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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