347005427-10-2-2024-59-AS-KHOS-DA6PPH-20241018112933

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347005427
Report Date: 10/02/2024
Date Signed: 10/02/2024 09:31:55 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 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
09/09/2024 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20240909131359

FACILITY NAME:	OAKMONT OF FOLSOM		FACILITY NUMBER:	347005427
ADMINISTRATOR:	CLYMO, MICHAEL		FACILITY TYPE:	740
ADDRESS:	1574 CREEKSIDE DR		TELEPHONE:	(916) 817-4500
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	88	CENSUS: 70	DATE:	10/02/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Michael Clymo, Administrator		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Facility is malodorous
Staff are not meeting residents' hygiene needs
Facility is unkempt

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to deliver complaint investigations. LPA met with administrator Michael Clymo during today’s inspection.
LPA investigated allegation, “Facility is malodorous”. LPA toured the facility and interviewed staff. LPA toured the facility on 9/11/24 and observed the memory care unit to be clean, sanitary, and free from odor. LPA toured resident rooms, common areas, kitchen area, and dining room and did not smell an odor. LPA interviewed 5 staff members in which they stated housekeeping and other staff keep the memory care clean and free from odor. Staff stated due to resident incontinence care needs, at times their may be a temporary smell but staff take care of the problem in a timely manner. Due to interviews and observation LPA finds allegation to be UNFOUNDED.
Continuation on 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024

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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Control Number 59-AS-20240909131359

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: OAKMONT OF FOLSOM	FACILITY NUMBER: 347005427
	VISIT DATE: 10/02/2024

NARRATIVE

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LPA investigated the allegation, “Staff are not meeting residents’ hygiene needs”. LPA toured the memory care unit, and observed common living spaces, and resident rooms. LPA observed resident rooms appeared to be clean and free from odor. LPA observed residents in care engaged in an activity, and residents appeared to be clean, dressed well, and comfortable. LPA interviewed 5 staff members in which they stated they provide routine incontinence care to residents in need and change them frequently throughout the shift. Staff stated they have not observed any of the resident’s hygiene needs not being met. Staff stated they believe they have enough staff per shift to meet resident needs. Relevant party indicated some residents have a smell to them and there are not enough staff to meet their needs, however no specific information was provided. Due to observation and interviews, LPA finds allegation to be UNFOUNDED.

LPA investigated allegation, “Facility is unkempt”. LPA toured the memory care unit which included resident rooms, common areas, kitchen and dining room area, and outdoor areas. LPA observed the memory care unit to be clean and free from odor. LPA observed the kitchen and dinning room area to be sanitary and clean. LPA interviewed 5 staff members in which they stated housekeeping and other staff keep the memory care clean and free from odor. Relevant party indicated there was standing water and dirty fans in the memory care unit, LPA did not observe any of these issues. Due to observation and interviews, LPA finds allegation to be unfounded.
The allegation is 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.

Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024

LIC9099 (FAS) - (06/04)

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