<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216804022
Report Date: 08/25/2022
Date Signed: 08/29/2022 03:25:39 PM


Document Has Been Signed on 08/29/2022 03:25 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: 0DATE:
08/25/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ric Pielstick - Executive DirectorTIME COMPLETED:
09:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Manager Bethany Moellers, Licensing Program Analyst Carla Fernandes-Goes met with Ric Pielstick - Executive Director, Sue McPherson - VP of Regulatory , Mark Maclaine - Vice President of Operations for Novato, Jennifer Sato - Regional Health Service Director Specialist. This meeting was conducted virtually due to COVID-19.

This meeting is being conducted to ensure that Executive Director is aware and understands non-compliance plan in place and review documentation that is required from facility under # 87211 Reporting Requirements. Facility understands that internal documentation can be requested by the Department based on Title 22 Regulations. In addition, it was discussed the importance of making sure that all necessary incidents are reported and in a timely matter.

The licensee was informed that additional civil penalties are under review by the Department per Health and Safety Code 1569.49 (f) due to substantiated complaint #21-AS-20210310171803 & one more under Priority 1 complaint under investigation for formal facility #216803904 Oakmont of Novato.

There were no deficiencies cited at this time.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Carla Fernandes-GoesTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1