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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216804022
Report Date: 11/06/2025
Date Signed: 12/18/2025 02:51:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2025 and conducted by Evaluator Anthony Loera
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20251104102911
FACILITY NAME:OAKMONT OF NOVATOFACILITY NUMBER:
216804022
ADMINISTRATOR:DAVIS, SCOTTFACILITY TYPE:
740
ADDRESS:1465 S. NOVATO BLVD.TELEPHONE:
(628) 215-1200
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:118CENSUS: 85DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Scott Davis, Executive DirectorTIME COMPLETED:
12:55 PM
ALLEGATION(S):
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Facility staff are not providing adequate supervision resulting in altercations between residents
INVESTIGATION FINDINGS:
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On 12/18/2025, Licensing Program Analyst (LPA) Loera arrived unannounced to conduct a complaint investigation and delivering complaint findings. LPA arrived and met with Executive Director, Scott Davis. During the investigation, LPA reviewed records and made observations.
Compliant alleges, facility staff are not providing adequate supervision resulting in altercations between residents.
Based on LPAs observations and record reviews, the following determination had been made, resident (R1) was involved in an altercation with resident (R2) on 10/11/2025. Community Care Licensing (CCL) received an incident report on 10/17/2025, regarding R1 and R2, stating on 10/11/2025 around 4:15am, R1 was found yelling in the hallway for help and said R2 came into their room and “slapped them in the face”. Staff (S1) went into R1s room and found R2 still in the room and was still agitated and was not re-directable. Police were called to take a report and helped escort R2 back into their own room. No injuries were noted or visible.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.
**Report amended as citation does not reflect allegation**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 21-AS-20251104102911
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: OAKMONT OF NOVATO
FACILITY NUMBER: 216804022
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
11/13/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by:
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Licensee to conduct training for all care staff regarding personal rights of residients. Licensee to provide scheduled training date to CCL by POC due date of 11/13/2025. Licencee to submit proof of completed training for all care staff to CCL by POC due date 11/27/2025.
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Based on observation and document review, the licensee did not comply with the section cited above as R2 slapped R1 in the face which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
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