392701014-12-14-2023-27-AS-LRIS-CYQNNJ-20231221093647

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701014
Report Date: 12/14/2023
Date Signed: 12/14/2023 10:57:31 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/18/2023 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20230718104646

FACILITY NAME:	OAKMONT OF LODI		FACILITY NUMBER:	392701014
ADMINISTRATOR:	SARA MACKEDSY		FACILITY TYPE:	740
ADDRESS:	2905 REYNOLDS RANCH PARKWAY		TELEPHONE:	(949) 744-5200
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	0	CENSUS: 91	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Andrea Armstrong, Administrator		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Staff withheld resident's medication resulting in hospitalization
Staff did not follow resident's care plan
Staff did not follow prescribed medication orders
Staff mismanaged resident's medication

INVESTIGATION FINDINGS:

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On 12/14/2023, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to the facility at approximately 8:30 am to complete an investigation and present the findings. LPA Campbell met with Administrator Andrea Armstrong and stated the purpose of the visit.

Regarding the allegation that staff withheld resident’s medication resulting in hospitalization, LPA Campbell interviewed staff and reviewed documentation for prescription orders. Due to ongoing issues with updating R1’s address, and because the facility is unable to change the address for R1, medication was delayed. When the POA did not change the address, medication had to be reordered repeatedly.

Regarding the allegation that staff did not follow resident’s care plan, LPA Campbell reviewed facility documentation that stated, only medically trained nurses can take blood pressure when it is used to determine the need for medication. S1 stated that R1’s POA was informed of this requirement. S2 reported that the doctor was informed that the facility could not hand out medication based on blood pressure readings, but the doctor never replied.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee Campbell	TELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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-20230718104646

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKMONT OF LODI	FACILITY NUMBER: 392701014
	VISIT DATE: 12/14/2023

NARRATIVE

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. Blood pressure measurements were observed for R1 in The Medication Administration Record (MAR). Per facility Policy 619, the POA was notified only licensed healthcare workers could perform this service per S2.

Regarding the allegation staff did not follow prescribed medication orders, LPA observed documentation from the pharmacy with the incorrect address for R1. Because the address had not been updated, the medications would not have arrived to the facility. S1 stated that the reporting party did not update the address per R1’s chart notes, The RP was upset that the facility would not update the information for them, and RP had to pick up the medication herself until the address was corrected. Per R1’s file, medication had to be ordered repeatedly due to incorrect the incorrect address.

Regarding the allegation that staff mismanaged resident’s medication, the RP stated that staff continued to urge her to take Tylenol instead of Hydrocodone. Per R1’s prescription, they were to take Hydrocodone-Acetaminophen which would include Tylenol taken with Hydrocodone as prescribed. Staff were therefore providing medication as directed.

The RP also alleged that pain medication was missing. The Medication Administration Record was observed, and staff reported that the medication was counted in error because they did not take into account the medication that had already been taken. Staff then notified the POA . No staff reported that the medication was missing or not dispersed. The Medication Administration Record shows that the all the medication was taken as directed unless R1 refused to take it or was not present in the facility. No evidence was found that medication was not provided or was mismanaged.

The Department find these allegations to be Unsubstantiated. A finding that a complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with the Administrator.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee Campbell	TELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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