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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701014
Report Date: 05/24/2022
Date Signed: 05/24/2022 11:24:25 AM


Document Has Been Signed on 05/24/2022 11:24 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 LODIFACILITY NUMBER:
392701014
ADMINISTRATOR:PRYOR, JESSICAFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(949) 744-5200
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: DATE:
05/24/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jessica Pryor, Executive Director TIME COMPLETED:
11:20 AM
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An informal conference was conducted today in the Sacramento Regional Office via Microsoft Teams. The purpose of this informal conference meeting is to discuss a substantiated complaint on 11/12/2021, and increased complaints within two months. Present in the meeting is Oakmont of Lodi Vice President of Operations, Terri Ervin, Senior Vice President of Regulatory Affairs ,Sue McPherson, Executive Director, Jessica Pryor, Licensing Program Manager (LPM) Liza King, and Licensing Program Analyst (LPA) Treana White, LPA Renee Campbell. The informal conference process was explained during this meeting.

Issues discussed during the meeting were:
· Medications training
· Facility is short staff and currently using 3 to 4 on call staff in memory care unit through staffing agency
· Incontinence Care
· In-service training for current and new staff
The RO recommends:
· Licensee will send in-service records of trainings provided for the next 6 months.
· Licensee will conduct quarterly Town Hall Meetings with staff.
· Licensee will conduct quarterly Town Hall Meetings with Responsible Parties of Assisted Living Residents.
· Licensee will conduct Town Hall meeting with families of the Traditions Program quarterly.

The facility has stated they will do the following to achieve continued and substantial compliance:
· Licensee will schedule a MT retraining and/or refresher course quarterly for the next 6 months. Last training was conducted on May 3, 2022. Documentation will be sent to LPA.
· Licensees agrees to send the LPA a copy of the facilities onboarding checklist for contracted staff, facility staff and directors.
· Licensee will seek an outside agency to provide formal training on Medication Training and send dates of training with Agency name to LPA White.
· Licensee will conduct Town Hall meeting with families of the Traditions Program to create better lines of communication with management by July 15, 2022.
Report continues on 809C.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana WhiteTELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 05/24/2022
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...Continued from LIC 809

Licensee agrees to send requested documents to LPA White, LPM King, and by 06/03/2022.

At this time, no deficiencies are cited. An exit interview was conducted with Executive Director via telephone and a copy of this report will be provided to the facility via email. A copy must be signed and returned to Community Care Licensing (CCL) and the one copy is to be retained by the facility.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana WhiteTELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC809 (FAS) - (06/04)
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