312700863-4-7-2022-25-AS-KHOS-CDUMQW-20220426094924

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700863
Report Date: 04/07/2022
Date Signed: 04/07/2022 03:40:06 PM

Unsubstantiated

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
02/16/2022 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 25-AS-20220216121134

FACILITY NAME:	OAKMONT OF WESTPARK		FACILITY NUMBER:	312700863
ADMINISTRATOR:	CASSIANA BUSH		FACILITY TYPE:	740
ADDRESS:	2400 PLEASANT GROVE BLVD		TELEPHONE:	(916) 789-2000
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	142	CENSUS: 87	DATE:	04/07/2022
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Antonette Edwards, Executive Director		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Facility staff do not maintain complete records for residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kerry Hiratsuka, and Lavinia Muscan, arrived at the facility unannounced on 04/07/2022, to conduct a Complaint Investigation Visit. LPA conducted COVID-19 Precautionary prescreening, and wore a surgical mask while at facility. LPA was screened by Front Desk.

LPA Hiratsuka, investigated the allegation “Facility staff do not maintain complete records for residents in care.” LPA interviewed staff. LPA Hiratsuka, reviewed four resident files on 03/16/2022, and all were complete. They were not organized in a folder, but they were complete. LPA cannot prove or disprove the records were incomplete prior to visit.

Based on the above, LPA cannot prove or disprove the facility resident files were missing information prior to 03/16/2022, the allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry Hiratsuka	TELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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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