342701121-1-13-2023-27-AS-KHOS-CN8RXV-20230119122522

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701121
Report Date: 01/13/2023
Date Signed: 01/13/2023 12:38:53 PM

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
01/06/2023 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230106163249

FACILITY NAME:	OAKMONT OF EAST SACRAMENTO		FACILITY NUMBER:	342701121
ADMINISTRATOR:	LUIS OLIVAS		FACILITY TYPE:	740
ADDRESS:	5301 F STREET		TELEPHONE:	(916) 905-2400
CITY:	EAST SACRAMENTO	STATE: CA	ZIP CODE:	95819
CAPACITY:	214	CENSUS: 150	DATE:	01/13/2023
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Luis Olivas		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Staff did not meet with responsible party for reappraisal meeting
-Staff do not shower resident

INVESTIGATION FINDINGS:

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

On 1/13/23 at 9:50AM, 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 did not meet with responsible party for reappraisal meeting, the Department found the following; based on interview and record review, it was determined that Resident 1(R1) had a healthcare POA, who was not the complainant. The healthcare POA was present for this reappraisal meeting that occured on 12/15/22.

Regarding the allegation of Staff do not shower resident, the Department found the following; based on interview and record review, it was determined that R1 gets showers twice a week and there is documentation confirming this. Staff note if the resident refuses as well.
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.

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: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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 2

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
01/06/2023 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230106163249

FACILITY NAME:	OAKMONT OF EAST SACRAMENTO		FACILITY NUMBER:	342701121
ADMINISTRATOR:	LUIS OLIVAS		FACILITY TYPE:	740
ADDRESS:	5301 F STREET		TELEPHONE:	(916) 905-2400
CITY:	EAST SACRAMENTO	STATE: CA	ZIP CODE:	95819
CAPACITY:	214	CENSUS: 150	DATE:	01/13/2023
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Luis Olivas		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Staff do not meet resident's dietary needs

INVESTIGATION FINDINGS:

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

On 1/13/23 at 9:50AM, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegation. LPA Hopkins met with Executive Director Luis Olivas and explained the purpose of today's visit.

Regarding the allegation of Staff do not meet resident's dietary needs, the Department found the following; based on record review, it was determined that Resident 1(R1) is receving a diet suitable for his/her diabetic needs. Staff follow R1's LIC602, and keep a binder for each resident that has dietary restrictions/needs. R1 is provided 3 snacks throughout the day as well. Although the allegations may have happened and/or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted with Executive Director Luis Olivas. A copy of this report was left upon exit.

Unsubstantiated

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: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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

LIC9099 (FAS) - (06/04)

Page: 2 of 2