392701014-11-30-2021-27-AS-LKIG-C9P263-20211213160629

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701014
Report Date: 11/30/2021
Date Signed: 11/30/2021 03:12:30 PM

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
11/29/2021 and conducted by Evaluator Treana White

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20211129143256

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: 65	DATE:	11/30/2021
		UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Jessica Pyyor, Executive Director		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Staff did not allow resident to have phone calls and messages

INVESTIGATION FINDINGS:

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On 11/30/2021, Licensing Program Analyst (LPA) T. White conducted an unannounced complaint investigation regarding the above allegation. LPA White discussed the purpose of the visit and the elements of the allegation with Executive Director, Jessica Pryor.During the course of investigation, LPA interviewed 3 staff members and 3 residents. LPA collected the following documents: Resident Roster, Admission Agreement, Email Documentation, Power of Attorney and Resident #1 (R1) Physician's Report.

Based on information provided, Complaintant stated Staff #3 (S3) would not provide R1's information over the phone. Complaintant asked S3 if R1 lived at the facility and S3 stated she cannot provide that information. Based on documentation, complaintant was calling to get additional information on R1. Staff #1 (S1) stated it is against our policy to give out confidential information over the phone.

Report continues on 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana White	TELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021

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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Control Number 27-AS-20211129143256

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: 11/30/2021

NARRATIVE

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Based on documentation, Admission Agreement states residents will be responsible for telephone installation and services. Based on S1's interview, the facility does not provide landline services. S1 stated the resident is responsible for providing their own cellphone or purchasing a landline through the cable company. S1 stated the facility is unable to transfer calls over to residents. S1 stated the front desk is required to take a message and give it to the residents. It is up to the resident to return the message. LPA observed 3 residents had telephones in their apartment. 3 of 3 residents stated they receive phone calls through their personal phones. However, S3 informed the R1's family, who is the Power of Attorney (POA) of the phone call, but did not inform R1 of the message.

Based on information obtained, LPA determined these allegations to be UNSUBSTANTIATED- means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no citations being issued today.

Exit interview conducted with Executive Director and a copy of report given.

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana White	TELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021

LIC9099 (FAS) - (06/04)

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