315002955-7-26-2023-59-AS-KHOS-CU9PK4-20230731112230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315002955
Report Date: 07/26/2023
Date Signed: 07/26/2023 03:07:19 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/24/2023 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20230724152045

FACILITY NAME:	OAKMONT OF WESTPARK		FACILITY NUMBER:	315002955
ADMINISTRATOR:	EDWARDS, ANTONETTE		FACILITY TYPE:	740
ADDRESS:	2400 PLEASANT GROVE BLVD.		TELEPHONE:	(916) 545-8904
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	142	CENSUS: 102	DATE:	07/26/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jessica Pryor, Administrator		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff are not ensuring a healthful environment for residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to open complaint findings. LPA met with Administrator Jessica Pryor during today's inspection.

During today's inspection LPA conducted a facility tour which included resident common areas, and staff areas. LPA observed resident common areas were clean and free from odor. Administrator stated there is a housekeeping department who work 7 days week and clean throughout the facility which includes resident and staff areas. LPA observed all staff areas to be free of odor and no smoking signs placed throughout the breakroom. Due to observation and information gathered, LPA finds allegation to be unfounded.
Exit interview conducted.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023

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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