392701014-12-19-2023-27-AS-LRIS-CYQNNV-20231221093721

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701014
Report Date: 12/14/2023
Date Signed: 12/19/2023 09:20:15 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
08/04/2023 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20230804131419

FACILITY NAME:	OAKMONT OF LODI		FACILITY NUMBER:	392701014
ADMINISTRATOR:	EUGENIA SMITH		FACILITY TYPE:	740
ADDRESS:	2905 REYNOLDS RANCH PARKWAY		TELEPHONE:	(949) 744-5200
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	0	CENSUS: 86	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Andrea Armstrong, Administrator		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide adequate supervision resulting in resident eloping from facility
Administrators are not present to manage the facility
Resident was denied access to their personal storage space

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 12/14/23, Licensing Program Analyst Renee Campbell arrived unannounced to the facility to present findings for an investigation. LPA Campbell met with Administrator Andrea Armstrong and stated the purpose of the visit.

Regarding the allegation that staff did not provide adequate supervision resulting in a resident eloping from the facility, per drill logs observed by LPA Campbell, the facility was holding a drill for resident elopements on the same date of 07/31/23. The event included staff who portrayed residents and families, who were upset that a family member eloped. There was no record of other residents who had eloped during the same period. Because there was no elopement, there was no lack of supervision.

Regarding the allegation that administrators are not present to manage the facility, per the reporting party, it was reported that an administrator could not be found on 07/31/23. When the administrator (S5) for that day was interviewed, she stated that whenever an administrator was unavailable, there was always a Manager of the Day (from the pool of department supervisors) assigned who would step in.

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)

Page: 1 of 2

Control Number 27-AS-20230804131419

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

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
26
27
28
29
30
31
32

The Manager of the Day was scheduled day to day. Because the Reporting Party (RP) asked specifically to speak to Tommy (Nurse), the staff would not have known to refer the Reporting Party to the Manager of the Day.

Regarding the allegation that residents were denied access to their personal storage space, because R1 was no longer at the facility, LPA Renee Campbell spoke with three residents regarding their storage. All three residents reported having access to their storage and all three reported no staff or other residents had used the storage other than themselves.

Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, and therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the facility.

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)

Page: 2 of 2