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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609905
Report Date: 10/09/2020
Date Signed: 10/09/2020 02:12:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:OAKMONT OF SANTA CLARITAFACILITY NUMBER:
197609905
ADMINISTRATOR:GINA SALMANFACILITY TYPE:
740
ADDRESS:28650 NEWHALL RANCH ROADTELEPHONE:
(661) 295-2025
CITY:SANTA CLARITASTATE: CAZIP CODE:
91355
CAPACITY:121CENSUS: 76DATE:
10/09/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jeff Caves/ Regional Executive DirectorTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA), Patrick Shanahan, conducted a virtual case management visit to this facility. This visit was conducted over facetime video.

With the assistance of the Regional Executive Director, the LPA was able to tour the physical plant of the facility. All common areas were socially distanced from each other and only couples were observed within close proximity. Hand sanitizing stations were observed through the facility and in the common areas. Center for Disease Control signs, reminding staff and residents to wash hands and wear a mask, were observed throughout the facility. Temperatures of all staff, residents and visitors are taken at the front desk upon entry.

LPA was also able to speak with staff regarding facility safety and the proper use of PPE. Staff interviewed did not have any concerns regarding their safety and felt that the facility has made every attempt to protect them and the residents.

LPA was also able to review several care plans for some of the residents. Care plans observed were up to date and are re-evaluated every 6 months or as needed.

Based on LPA observations,and staff interviews, no concerns were observed during todays visit.

Due to the COVID-19 pandemic, this visit was conducted virtually, therefore a digital signature was not secured. LPA emailed this report to the Executive Director and a "wet" signature was collected. A copy of the "Wet" signature will be on file in the Regional Office.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020
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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