342701121-8-18-2022-27-AS-KHOS-CHLL7H-20220824083021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701121
Report Date: 07/26/2022
Date Signed: 08/18/2022 09:26:28 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/25/2022 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20220525114601

FACILITY NAME:	OAKMONT OF EAST SACRAMENTO		FACILITY NUMBER:	342701121
ADMINISTRATOR:	ERVIN, TERENCE		FACILITY TYPE:	740
ADDRESS:	5301 F STREET		TELEPHONE:	(916) 905-2400
CITY:	EAST SACRAMENTO	STATE: CA	ZIP CODE:	95819
CAPACITY:	214	CENSUS: 140	DATE:	07/26/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Luis Olivas		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Staff are allowing resident to give medications to another resident
-Staff are allowing another resident to open resident's mail
-Staff are allowing another resident to bathe resident
-Staff allowed another resident to change resident catheter
-Staff are allowing another resident to dress another resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

This is an Amended document previously delivered on 7/26/22 at 10:00AM. Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegations. LPA Hopkins met with Executive Director Luis Olivas and explained the purpose of today's visit.

Regarding the allegation of Staff are allowing resident to give medications to another resident, the Department found the following: based on interview and record review it was determined that Resident 1(R1) was never taking any medications. R1's Medication Administration Record shows R1 was never taking any medication. R1 also stated that he/she was never taking any medication.

Report Continued on LIC9099-C...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 27-AS-20220525114601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: OAKMONT OF EAST SACRAMENTO	FACILITY NUMBER: 342701121
	VISIT DATE: 07/26/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation of Staff are allowing another resident to open resident's mail, the Department found the following: based on interview, it was determined that R1 gave a copy of his/her mail key to Resident 2(R2) so he/she could retrieve the mail for R1. R1 knows R2 has a key, and often times asks R2 to get his/her mail because the mail slot is too deep and he/she cant reach all the way back.

Regarding the allegation of Staff are allowing another resident to bathe resident, the Department found the following: based on interview and record review, it was determined that R1 is independent and capable of bathing him/herself. Both R1 and R2 deny ever letting R2 bathe R1.

Regarding the allegation of Staff allowed another resident to change resident catheter, the Department found the following: based on interview and record review, it was determined that R1 never had a catheter in March 2022. The last time R1 had a catheter was sometime in July 2021. R1 and R2 deny letting R2 change R1's catheter. R2 stated he/she was not capable of changing any catheter and that would be illegal. R1 stated his/her catheter was changed by the doctor.

Regarding the allegation of Staff are allowing another resident to dress another resident, the Department found the following: based on interview and record review, it was determined that R1 is independent and capable of dressing his/herself. R1 and R2 deny ever helping R1 get dressed.

Based on the investigation conducted the allegations are UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted with Luis Olivas and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2