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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216804022
Report Date: 07/06/2023
Date Signed: 07/06/2023 04:21:39 PM


Document Has Been Signed on 07/06/2023 04:21 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:OAKMONT OF NOVATOFACILITY NUMBER:
216804022
ADMINISTRATOR:PIELSTICK, RICFACILITY TYPE:
740
ADDRESS:1465 S. NOVATO BLVD.TELEPHONE:
(628) 215-1200
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:118CENSUS: DATE:
07/06/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Ric Pielstick (Executive Director)TIME COMPLETED:
04:00 PM
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An office meeting was conducted today in the Santa Rosa Regional Office via Microsoft Teams. Present in the meeting were Licensing Regional Manager Carla Nuti-Martinez, Licensing Program Manager Bethany Moellers, Licensing Program Analyst Marisol Cuadra, Executive Director Ric Pielstick, Vice President of Regulatory Sue McPherson, Vice President of Operations for Novato Mark Maclaine, Regional Health Service Director Specialist Courtney Clark, Health Service Director Specialist Kimari Pinkney and Community Marketing Director Liza Hiz.

The purpose of this office meeting is to discuss Non-Compliance plan (NCC) from facility Oakmont of Novato # 216804022 which will be extended due to items of concerns about the operation of the facility not been resolved. Parties present during this call agreed to extend the Non-compliance plan until 7/2/2024. Original NCC plan went into effect 7/22/21. Ten complaints since licensure date of 6/9/2022. The Regional Office will re-review progress made on Non-Compliance Plan of one year prior to expiration date. At the time of initial Non-Compliance Conference, CCL received policies and proof of corrections for non-compliance items found during complaint investigations substantiated findings. Areas of improvement have been identified as food service, prohibited condition and reporting requirements. Areas of compliance not limited to below were discussed:
- Timely Medical Attention: Facility failed to seek timely medical attention.
- Staffing: Facility memory care unit didn't have adequate number of direct care staff to support each resident's physical, social, emotional, safety and health care needs.
- Medications: Facility did not ensure that resident’s medications were properly handled, secured per resident’s physician reports on file resulting in medication errors.
- Resident Records: Facility did not ensure that resident’s medical assessments and updated resident's care notes were available for review.
In today's meeting, it was discussed that The Department has additional civil penalties under review.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Marisol CuadraTELEPHONE: (707) 588-5078
LICENSING EVALUATOR SIGNATURE:
DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/06/2023
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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