107209036-10-24-2023-24-AS-SPIY-CZTTT2-20240125140000

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107209036
Report Date: 10/16/2023
Date Signed: 10/24/2023 09:16:06 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/10/2023 and conducted by Evaluator Katie Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20231010161832

FACILITY NAME:	OAKMONT OF NORTH FRESNO		FACILITY NUMBER:	107209036
ADMINISTRATOR:	SETTY, HEIDI		FACILITY TYPE:	740
ADDRESS:	5605 N GATES AVE		TELEPHONE:	(559) 277-5959
CITY:	FRESNO	STATE: CA	ZIP CODE:	93722
CAPACITY:	122	CENSUS: 76	DATE:	10/16/2023
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Heidi Setty		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
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9

Facility staff do not provide adequate assistance to resident in care.
Resident room is malodorous.

INVESTIGATION FINDINGS:

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9
10
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Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the initial 10-Day complaint visit. LPA met with and explained the reason for the visit with Administrator (AD) Heidi Setty.

During the visit LPA observed R1's room. R1 was observed clean and resting comfortably in bed. LPA observed R1 again during lunch and interviewed R1. R1's room and bathroom were odor free during the visit. LPA conducted staff and Hospice Nurse interviews and reviewed R1's file. LPA reviewed Staff Assignment sign off sheets for August, September and October 2023. Based on the above, the above allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur.

There were no citations issued An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt of these documents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Katie Brown	TELEPHONE: (559) 498-9964
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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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