216804022-11-15-2022-21-AS-BMOS-CLENKP-20221122093215

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216804022
Report Date: 11/15/2022
Date Signed: 11/15/2022 09:27:50 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, 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
09/19/2022 and conducted by Evaluator Marisol Cuadra

PUBLIC

COMPLAINT CONTROL NUMBER: 21-AS-20220919203355

FACILITY NAME:	OAKMONT OF NOVATO		FACILITY NUMBER:	216804022
ADMINISTRATOR:	PIELSTICK, RIC		FACILITY TYPE:	740
ADDRESS:	1465 S. NOVATO BLVD.		TELEPHONE:	(628) 215-1200
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	118	CENSUS: 83	DATE:	11/15/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ric Pielstick (Executive Director)		TIME COMPLETED:	09:42 AM

ALLEGATION(S):

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Facility did not provide resident's records to responsible party.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cuadra arrived unannounced to the facility met with Executive Director (Administrator), Ric Pielstick to deliver findings regarding the complaint allegation above.

It was alleged that the facility did not provide resident’s records to responsible party. Per Reporting party alleged that facility staff is not allowing authorized representative to obtain resident’s (R1) records. Based on records review, on 8/17/22 R1 signed an authorization for a legal services firm to represent and obtain R1’s records. On 8/26/22 facility received a request from law firm representing R1 requesting a copy of resident’s records. Based on confidential interviews, LPA was informed by facility Legal Department that the records were released to R1’s responsible party as of 11/3/2022 after confiming the validity of the legal services firm to represent R1. Based on information received by the facility Legal Department and reporting party, it was confirmed that records were provided to R1’s responsible party. A finding that the complaint allegation “Facility did not provide resident's records to responsible party” is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bethany Moellers	TELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Marisol Cuadra	TELEPHONE: (707) 588-5078
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022

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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