392701014-9-9-2022-27-AS-LKIG-CJWQZN-20221005123700

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701014
Report Date: 09/09/2022
Date Signed: 09/09/2022 05:51:09 PM

Unsubstantiated

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
09/01/2022 and conducted by Evaluator Michael Bilger

COMPLAINT CONTROL NUMBER: 27-AS-20220901161705

FACILITY NAME:	OAKMONT OF LODI		FACILITY NUMBER:	392701014
ADMINISTRATOR:	PRYOR, JESSICA		FACILITY TYPE:	740
ADDRESS:	2905 REYNOLDS RANCH PARKWAY		TELEPHONE:	(949) 744-5200
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	136	CENSUS: 103	DATE:	09/09/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sara Mackedsy		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff are not helping residents with dressing needs
Staff are not helping residents with toileting needs
Staff are not ensuring residents rooms are clean

INVESTIGATION FINDINGS:

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On 9-9-22 at 1:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with Administrator Sara Mackedsy and explained the purpose of the visit. During this investigation, LPA interviewed five staff members including Administrator. LPA also interviewed five residents. LPA also reviewed housekeeping cleaning schedule, staffing schedule for August 2022, and actual hours worked for August 2022. Additionally, LPA conducted a facility observation.

Allegation #1: Staff are not helping residents with dressing needs: LPA interviewed Staff1 (S1), S2, S3, S4, as well as Resident1 (R1), R2, R3, R4, and R5. LPA also reviewed staffing schedule and actual hours worked for August of 2022 and conducted facility observation. Based on interviews, record review, and observation, it was determined that residents are receiving routine assistance as needed for dressing needs. LPA observed one med tech and 2 caregivers for assisted living, and 1 med tech and 3 caregivers for memory care. Based on interviews it was further determined that additional needs are met routinely based on the staffing levels. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. {Cont. on 9099C}

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael Bilger	TELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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 27-AS-20220901161705

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 LODI	FACILITY NUMBER: 392701014
	VISIT DATE: 09/09/2022

NARRATIVE

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Allegation #2: Staff are not helping residents with toileting needs. LPA interviewed Staff1 (S1), S2, S3, S4, as well as Resdient1 (R1), R2, R3, R4, and R5. LPA also reviewed staffing schedule and actual hours worked for August of 2022 and conducted facility observation. Based on interviews, record review, and observation, it was determined that residents are receiving routine assistance as needed for toileting needs. LPA observed one med tech and 2 caregivers for assisted living, and 1 med tech and 3 caregivers for memory care. Based on interviews it was further determined that additional needs are met routinely based on the staffing levels. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation #3: Staff are not ensuring residents rooms are clean. LPA conducted facility observation of twelve rooms and interviewed Resident1 (R1), R2, R3, R4 and R5. LPA also interviewed Staff1 (S1), S2, S3, S4, and S5. Additionally, LPA reviewed housekeeping schedule. During facility tour, LPA observed rooms to be clean and free of clutter and trip hazards. Rooms’ floors, walls, countertops, and furniture were clean. Bathrooms and kitchen areas were clean. Rooms did not contain any foul odors. Based on interviews conducted, it was revealed that housekeeping performs services according to schedule. LPA also observed housekeeping carts and housekeepers cleaning various rooms during tour. Based on record review, observations, and interviews conducted, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

No citations issued today as a result of this investigation. An exit interview was conducted with Sara Mackedsy and a copy of this report was left with Sara. Appeal Rights provided.

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael Bilger	TELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC9099 (FAS) - (06/04)

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