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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701121
Report Date: 09/22/2023
Date Signed: 09/22/2023 04:40:49 PM

Substantiated


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
07/28/2023 and conducted by Evaluator Kevin Gould
COMPLAINT CONTROL NUMBER: 27-AS-20230728113120
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: 146DATE:
09/22/2023
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Luis OlivasTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Personal Rights: Staff stole and fraudulently used residents credit cards.
Reporting Requirements: Facility is not adhering to reporting requirements.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Oakmont of East Sacramento on 9/22/23 at 2:15pm to conclude the investigation of the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details.

Based on the interviews and statements obtained during the investigation process, the allegations have been corroborated. The facility has self reported four instances of credit card theft and unauthorized credit card use. LPA interviewed three of the victims and two of the resident's interviewed were able to confirm that their credit cards were stolen and used without prior authorization. The facility had reported the instances of theft to local police department who concluded their investigation and arrested a staff member S1 (see confidential names list, LIC 811 dated 9/22/23) and is being charged with 12 felony counts per Administrator.

Report Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
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 5
Control Number 27-AS-20230728113120
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: 09/22/2023
NARRATIVE
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Regarding reporting requirements, the facility did not complete all processes in regard to mandated reporting. The facility did submit incident reports to the department regarding theft of and unauthorized use of resident's credit cards. In total, there have been four (4) identified victims as were reported by the facility. The facility reported to local law enforcement. However, the facility did not meet all reporting requirements as the facility was also required to submit a suspected dependent adult/elder abuse to the local ombudsperson within two working days of being made aware of the suspected abuse. The facility did not meet all reporting requirements.

The Department has determined, based on the preponderance of the evidence obtained during this investigation, that the allegations of Personal Rights and Reporting Requirements are substantiated but if any additional information is received this complaint can be amended and the finding can be changed.

The following deficiencies are cited per California Code Regulation, TITLE 22.

Exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
07/28/2023 and conducted by Evaluator Kevin Gould
COMPLAINT CONTROL NUMBER: 27-AS-20230728113120

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: DATE:
09/22/2023
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Luis OlivasTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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2
3
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5
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9
Other: facility is not following theft/loss policy.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kevin Gould made an unannounced inspection to the Oakmont of East Sacramento on 9/22/23 at 2:15pm to conclude the investigation of the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details.

Based on the interviews conducted and documents obtained during the investigation process, the allegations cannot be corroborated because the facility followed and documented all aspects of the theft loss policy per title 22 regulations. All reported financial losses were documented and reported to local law enforcement. The facility maintains a left/loss policy binder at the facility and the binder and facility actions corresponding to the theft loss policy and Title 22 regulations were all adhered to and the facility remains in substantial compliance in regards to theft loss policy.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20230728113120
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: 09/22/2023
NARRATIVE
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The Department has investigated the complaint alleging Other. Based on the investigative interviews, record reviews and other supportive evidence, the complaint is determined to be unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. The Complaint has been dismissed.

There are no deficiencies noted or cited per California Code Regulation, TITLE 22.

Exit interview was conducted with the facility administrator and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20230728113120
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2023
Section Cited
CCR
87468.2(a)(8)
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Additional Personal Rights of Residents in Privately Operated Facilities: To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidenced by four instances
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Faciilty has agreed to conduct retraining for all staff members on the personal rights of residents in a privatly operated faciilty and documentation of training and training materials will be submitted to the department by the POC due date.
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of theft of a resident's credit card and unauthorized use by a staff member who was arresed by local law enforcement while at the faclity on 9/12/23 which poses a potential health, safety and personal rights risk to resident's in care.
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Deficiency Dismissed
Type B
10/24/2023
Section Cited
CCR
87405(d)(2)
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Administrator - Qualifications and Duties: The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. Knowledge of and ability to conform to the applicable laws, rules
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The facility has agreed to conduct training for all staff members on Mandated reporting including but not limited to what is a mandated reporter, types of abuse, and how to fill out and submit a suspected dependant Adult/Elder abuse form (soc 341) and who and where to submit the document to complete the process of a mandated reporter.
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and regulations. This requirement was not met as evidenced by the facility did not meet all reporting requirements as identified in welfare institutions code for mandated reporting for financial abuse as a suspected dependent adult/elder abuse report should have been submitted to the local ombudsman within two working days. The Administrator had provided reports for three of the four instances but did not complete reporting requirements for the reported incident in March 2023. per welfare institutions code 15630.2.(b)(3) If the mandated reporter knows that the elder or dependent adult resides in a long-term care facility, as defined in Section 15610.47, the report shall be made to the local ombudsman, local law enforcement agency, and the Department of Financial Protection and Innovation. which poses a potential health safety and personal rights risk to residents in care.
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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) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5