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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701272
Report Date: 07/23/2024
Date Signed: 07/23/2024 02:31:54 PM


Document Has Been Signed on 07/23/2024 02:31 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:OAKMONT OF LODIFACILITY NUMBER:
392701272
ADMINISTRATOR:ARMSTRONG, ANDREAFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(209) 310-1512
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 98DATE:
07/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Andrea ArmstrongTIME COMPLETED:
03:00 PM
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On 07/23/2024 Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an post continuation required inspection. LPA Martinez met with Andrea Armstrong and explained the purpose of the visit.

LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.

Administrator holds current certificate. The facility has a total capacity of 136 residents, of which 8 may be bedridden. The facility has an approved hospice waiver for 15. There are currently 92 residents who reside at this facility.

LPA Martinez conducted staff interviews during today's post required inspection. On the June 03, 2024 visit, LPA toured the facility, which included common areas, kitchen, resident rooms, outside courtyard, and restrooms. Additionally, LPA Martinez conducted medication room inspection.

As a result of this continuation post licensing visit, the facility there were no deficiencies cited. An exit interview was conducted, and a copy of this 809 report was provided to the facility.

SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Avelina MartinezTELEPHONE: (916) 431-8935
LICENSING EVALUATOR SIGNATURE:
DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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