345002797-11-4-2021-25-AS-MSEY-C8KMT4-20211108085253

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002797
Report Date: 11/04/2021
Date Signed: 11/04/2021 02:06:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2021 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 25-AS-20211027110632

FACILITY NAME:	OAKMONT OF FAIR OAKS		FACILITY NUMBER:	345002797
ADMINISTRATOR:	CONDIE, NATHAN		FACILITY TYPE:	740
ADDRESS:	8484 MADISON AVE.		TELEPHONE:	(916) 633-1001
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	128	CENSUS: 63	DATE:	11/04/2021
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Ricky David		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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-Facility staff did not follow physicians order to obtain resident's contact lenses
-Facility staff did not safeguard resident's personal property

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Angela Hood and Michael Hood arrived at the facility today and met with Ricky David, Executive Director, to open a complaint investigation into the allegations listed above. Facility currently does not have any COVID-19 positive cases. LPAs wore N95 masks and were screened by facility upon entry. Facility staff wore masks in the care home.

This complaint was entered under the wrong facility number.

Based on records reviewed, the above allegations are found to be UNFOUNDED. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.

A copy of this report has been provided to facility. Exit interview conducted.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 214-0485
LICENSING EVALUATOR NAME: Angela Hood	TELEPHONE: 650-676-0390
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

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

LIC9099 (FAS) - (06/04)

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