Community Care Licensing

Document Has Been Signed on 12/08/2022 05:21 PM - It Cannot Be Edited

FACILITY NAME:	OAKMONT OF CARMICHAEL		FACILITY NUMBER:	342700751
ADMINISTRATOR:	KATHLEEN GILBEY		FACILITY TYPE:	740
ADDRESS:	4717 ENGLE ROAD		TELEPHONE:	(916) 483-3800
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY: 101		CENSUS: 74	DATE:	12/08/2022
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	05:00 PM
MET WITH:	Kathleen Gilbey, Administrator		TIME COMPLETED:	05:25 PM

SUPERVISORS NAME: Maribeth Senty LICENSING EVALUATOR NAME: Sabrina Calzada LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022

Link to Parent Document Below:

FACILITY NAME: OAKMONT OF CARMICHAEL	FACILITY NUMBER: 342700751
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/08/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/16/2023 Section Cited HSC 1569.69(a)(3)	1 2 3 4 5 6 7	§1569.69 Employees assisting residents with self-administration of medication; training requirements. (a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (3) An employee shall be required to complete the training requirements for hands-on shadowing training described in this subdivision prior to assisting any resident in the self-administration of medications. The training and instruction described in this subdivision shall be completed, in their entirety, within the first two weeks of employment. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee/Administrator agree to ensure all staff administering medication are current in their initial medication training. Documentation of completed required training to be sent to the Department by 12/22/22.
	8 9 10 11 12 13 14	Based on record review and interview conducted, the Licensee did not ensure that staff (S1 and S2) had the required initial shadow training prior to administering medications, posing a potential health and safety risk to residents in care.	8 9 10 11 12 13 14
Type B 01/16/2023 Section Cited HSC1569.69(b)	1 2 3 4 5 6 7	§1569.69 Employees assisting residents with self-administration of medication; training requirements: (b) Each employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee/Administrator agree to ensure all staff administering medication are current in their ongoing medication training. Documentation of completed required training to be sent to the Department by 12/22/22.
	8 9 10 11 12 13 14	Based on record review, the Licensee did not ensure that staff (S3)had completed the required ongoing medication training within the last 12 months from when the review was conducted on 10/11/22, posing a potential health and safety risk to residents in care.	8 9 10 11 12 13 14

SUPERVISOR'S NAME: Maribeth Senty LICENSING EVALUATOR NAME: Sabrina Calzada LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022