312700602-6-16-2021-25-AS-KMKY-C47RHT-20210621130253

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700602
Report Date: 06/16/2021
Date Signed: 06/16/2021 01:00:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/28/2021 and conducted by Evaluator Melana Llopis

COMPLAINT CONTROL NUMBER: 25-AS-20210528163831

FACILITY NAME:	OAKMONT OF ROSEVILLE		FACILITY NUMBER:	312700602
ADMINISTRATOR:	SMITH, AUSTRIA		FACILITY TYPE:	740
ADDRESS:	1101 SECRET RAVINE PARKWAY		TELEPHONE:	(916) 771-6700
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95661
CAPACITY:	120	CENSUS: 77	DATE:	06/16/2021
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Business Office Director, Angelique Doyle		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility increased resident's rental and care rate without notice.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Melana Llopis arrived at the facility unannounced on 06/16/2021 to deliver complaint findings for a complaint the Department received on 05/28/2021. LPA met with Business Office Director, Angelique Doyle and explained the purpose of the visit. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Mask.
***Throughout the course of the investigation, LPA conducted multiple interviews and reviewed documentation pertinent to the investigation.
Results are as follows:

***Continuation on LIC9099-C***

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Kevin Mknelly	TELEPHONE: (209) -81-1925
LICENSING EVALUATOR NAME: Melana Llopis	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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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Control Number 25-AS-20210528163831

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: OAKMONT OF ROSEVILLE	FACILITY NUMBER: 312700602
	VISIT DATE: 06/16/2021

NARRATIVE

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Allegation: Facility increased resident's rental and care rate without notice.

The complaint alleged the facility increased R1's rental and care rate without notifying R1 or their representative.
On 06/08/2021 LPA reviewed R1's admission agreement. The admission agreement indicates R1 was admitted into the facility on 03/31/2021 and their representative agreed to pay an initial community fee of $2000.00 and a monthly fee, to cover care and rent, of $9870.00. LPA reviewed R1's payment ledger on 06/08/2021 which indicates R1 was charged the community fee and total care and rent fee of $9780.00 for the month of April 2021. R1's records reviewed on 06/08/2021 indicate on 03/31/2021, R1's representative signed a document showing the new cost of care for R1 was $4825.00. The document indicates the new cost of care was effective on 03/31/2021; R1 was charged $4875.00 on 04/01/2021 for cost of care and $4825.00 for the months of May and June 2021. On 06/10/2021, LPA spoke with a facility accountant who stated they would credit R1 $50.00 for the month of April 2021. No additional costs for care and/or rent were observed.

Due to the information provided, LPA finds the allegation to be UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted, copy of report and appeal rights provided.

SUPERVISOR'S NAME: Kevin Mknelly	TELEPHONE: (209) -81-1925
LICENSING EVALUATOR NAME: Melana Llopis	TELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC9099 (FAS) - (06/04)

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