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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701121
Report Date: 11/16/2023
Date Signed: 11/29/2023 01:51:34 PM


Document Has Been Signed on 11/29/2023 01:51 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:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Luis OlivasTIME COMPLETED:
03:30 PM
NARRATIVE
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On 11/16/2023 at 12:30 PM, Licensing Program Analyst (LPA) Pang Lee arrived at the facility unannounced to conduct a case management visit. LPA Lee met with administrator, Luis Olivas and explained the purpose of the visit. The census is 147.

The purpose of today’s visit is in response to concerns that was brought to the department attention on 10/30/2023. The concerns was addressed during family council on 09/09/2023 and 10/10/2023. Family council has submitted in writing concerns and recommendations to facility. It was learned that the administrator, Luis Olivas did not ensure responses are in writing regarding action or in action to address these concerns to the family council within the 14 calendar days. A family council was held on 09/09/2023 and no written response was provided until 09/28/2023. Furthermore a family council that was held on 10/10/2023 no written response was provided as of today. Per administrator, Luis, a verbal response was provided on 11/14/2023, during the November family council meeting. It was also learned that phone calls and emails were sent to both administrator, Luis Olivas and Vice President of Operations Terry Ervin.



The following deficiencies were observed and cited form California Code of Regulations, Title 22, and California Health and Safety Code. An exit interview was conducted, and a copy of this LIC 809 report, LIC 809-D and appeal rights were given to administrator, Luis Olivas.
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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Document Has Been Signed on 11/29/2023 01:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 SACRAMENTO
FACILITY NUMBER: 342701121

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2023
Section Cited
CCR
1569.158(f)

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§1569.158(f) Family councils
f a family council submits written concerns or recommendations, the facility shall respond in writing regarding any action or inaction taken in response to the concerns or recommendations within 14 calendar days.
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Administrator agrees to provide written response to concerns addressed during family councils meetings within 14 calendar days. Administrator also agrees to review regulation being cited today and write a
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statement of acknowledging that administrator is aware of the regulation being cited today. POC will be email to LPA Lee at pang.lee@dss.ca.gov by POC date 11/30/2023 by end of day 5:00 PM.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
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 appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023
LIC809 (FAS) - (06/04)
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