<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701014
Report Date: 06/15/2023
Date Signed: 06/15/2023 04:58:10 PM


Document Has Been Signed on 06/15/2023 04:58 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
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:OAKMONT OF LODIFACILITY NUMBER:
392701014
ADMINISTRATOR:SARA MACKEDSYFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(949) 744-5200
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 91DATE:
06/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eugenie Smith, AdministratorTIME COMPLETED:
05:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 06/15/2023, Licensing Program Analyst (LPA) Renee Campbell arrived at the facility at approximately 10:30 am and met with Eugenia Smith, Administrator, and explained the purpose of the visit. The Department received an incident report describing an attempted theft of a resident’s funds.

During the visit, LPA Campbell interviewed the administrator, reviewed the personnel file for a suspected staff (S1), resident rosters, R1’s admission agreement and 602. Bank records show that there were three attempts to cash R1’s checks without her permission and S1’s name was written on all the checks. Only one check was successfully cashed for $290. At this time no staff or residents witnessed S1 taking the checks. Interviews revealed that a resident had later seen S1 around the facility after she was terminated from the facility.

There is no deficiency cited at this time.

Exit interview with the Administrator.
.
SUPERVISOR'S NAME: Emerita CurielTELEPHONE: (916) 263-4707
LICENSING EVALUATOR NAME: Renee CampbellTELEPHONE: 916-206-6380
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1