392701272-12-13-2024-27-AS-LKIG-DCGPBX-20241231101105

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701272
Report Date: 12/12/2024
Date Signed: 12/13/2024 08:37:12 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
08/26/2024 and conducted by Evaluator Charlie Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240826133118

FACILITY NAME:	OAKMONT OF LODI		FACILITY NUMBER:	392701272
ADMINISTRATOR:	ARMSTRONG, ANDREA		FACILITY TYPE:	740
ADDRESS:	2905 REYNOLDS RANCH PARKWAY		TELEPHONE:	(209) 310-1512
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	136	CENSUS: 93	DATE:	12/12/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Andrea Armstrong		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not properly isolating residents in care.

Staff do not ensure restrooms have toiletries.

Staff do not ensure facility is kept clean and sanitized.

INVESTIGATION FINDINGS:

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

Unannounced complaint visit made out to this facility on 12/12/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Andrea Armstrong.
A brief interview was conducted with the facility designated Administrator at this time.
Current census was 93 residents.
The purpose of this complaint visit was to complete this investigation and present the findings to this facility, and its representative, at this time.
Based on a review of the forms and documents collected during the course of this investigation, it was learned that this facility used a vendor, Ecolab, for obtaining cleaning and maintenance supplies. In addition, another vendor, HD Supply, was used to obtain toiletries and trash bags as needed. It was observed that these orders were done on a monthly basis but it was also observed that additional orders were completed within the same month if more items were needed at that time.
A review of the facility restrooms was conducted. It was observed by this LPA that they contained an adequate supply of hand washing soap, paper towels, and toilet paper at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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-20240826133118

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: 392701272
	VISIT DATE: 12/12/2024

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

Based on a review of the facility policies and procedures in regards to Infection Control, the version that was submitted into CCL was last updated on 03/23/2022. It was observed that there was a section, Infection Control-17, which did outline the policies and procedures for Respiratory Illness Outbreak. This particular section of the facility Infection Control Policy was last updated on 12/15/2021.
It was observed that this section of the Infection Control Policy did address the need for isolation for the residents, and staff alike, if deemed to be infectious and a threat to the Health, Safety, and Personal Rights of the residents in care.
Based on a review of the forms and documents submitted into CCL, it was learned that facility staff were originally on boarded for a duration of 4 weeks after date of hire. The number of hours for the first 4 weeks of training amounted to total of 41 hours. It was learned that 2 hours of the overall 41 hours were dedicated to Personal Protective Equipment (PPE) and Infection Control and Prevention.

As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegations finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violations occurred.

There were no deficiencies observed or cited during todays complaint visit.

Exit Interview

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2