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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701121
Report Date: 11/16/2023
Date Signed: 11/16/2023 03:20:01 PM


Document Has Been Signed on 11/16/2023 03:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:OAKMONT OF EAST SACRAMENTOFACILITY NUMBER:
342701121
ADMINISTRATOR:LUIS OLIVASFACILITY TYPE:
740
ADDRESS:5301 F STREETTELEPHONE:
(916) 905-2400
CITY:EAST SACRAMENTOSTATE: CAZIP CODE:
95819
CAPACITY:214CENSUS: 147DATE:
11/16/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Luis OlivasTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Pang Lee arrived at the facility on 11/16/2023 at 12:30 PM to conduct an unannounced Plan of Correction (POC) visit. LPA Lee met with administrator, Luis Olivas and explained the purpose of the visit. The purpose of this visit is to follow-up on prior deficiency and plans of correction that were due on 11/07/2023 from a complaint investigation which was conducted on 10/24/2023. The census is 147.

As of the dated of this visit, 11/16/2023 at 12:30 PM, the department has not received any forms and documents from the administrator to support the plan of correction has been completed by the facility. Civil Penalties were assessed on today’s date for failure to correct 87303(i)(1)(B). The Facility was informed that the civil penalty will continue to accrue $100 per day per violation until the deficiency is corrected. However, during today's visit at 2:30 PM, administrator, Luis Olivas provided LPA Lee POC documents of training materials and staff sign in sheet for the Personal Health Button Report (PHBR) training. Administrator also provided statement of acknowledgement that administrator is aware of the regulation that was cited on 10/24/2023 and two audit (PHBR) logs.

Based upon this inspection and interview, the LPA observed the following:
I. The deficiency cited under Title 22 Regulation 87303(i)(1)(B) has been cleared. The licensee did not complied with the terms of the POC by POC due date 11/07/2023; however, during today's POC visit, administrator, Luis Olivas provided POC documents to LPA Lee. A POC letter was generated and provided to the facility.

An exit interview was conducted and a copy of this LIC 809 report, and civil penalties was provided to administrator, Luis at the end of this visit.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Pang LeeTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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