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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701014
Report Date: 08/18/2022
Date Signed: 08/18/2022 05:22:50 PM


Document Has Been Signed on 08/18/2022 05:22 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:OAKMONT OF LODIFACILITY NUMBER:
392701014
ADMINISTRATOR:PRYOR, JESSICAFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(949) 744-5200
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 94DATE:
08/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Jessie Kelly and Denise DeCarieTIME COMPLETED:
05:00 PM
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On 8/18/22 at approximately 3:45pm Licensing Program Analyst (LPA) Maja Jensen arrived unannounced at facility to conduct an abbreviated annual visit. An annual inspection was previously conducted on 3/29/22. LPA Jensen met with Regional Memory Care Specialist Jessie Kelly and Business Office Manager Denise Decarie and explained the purpose of today's visit. Denise DeCarie called Executive Director Sara Mackedsy by telephone and LPA Jensen also explained the purpose of today's visit to her.

LPA Jensen toured the facility including but not limited to the grounds, resident rooms, kitchen, dining hall and laundry room. Due to insufficient time the LPA will return at a later date to deliver the findings of the abbreviated annual inspection.

An exit interview was conducted and a copy of this report emailed to the Executive Director and Licensee.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2022
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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