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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701272
Report Date: 10/17/2024
Date Signed: 10/18/2024 08:25:06 AM


Document Has Been Signed on 10/18/2024 08:25 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
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: 96DATE:
10/17/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Asha PrasadTIME COMPLETED:
04:30 PM
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Unannounced case management visit made out to this facility on 10/17/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the Business Office Director, Asha Prasad, who was briefly interviewed at this time.
Current census was 96 residents.
The purpose of this case management visit was to follow up on the quarterly visits that were required since the last one that was conducted took place on 07/25/2024.
The following items were required to be monitored and maintained in compliance at all times:
  1. Staffing Concerns: Job Fairs will be conducted and continuous hiring.
  3. Medication Errors: A medication error was reported to Community Care Licensing Department (CCLD) by the facility.
  5. Medication Audit: A medication audit was completed on July 18, 2024.
  7. Reporting Requirements: The Department has received incident reports from the facility.
  9. Medication Training: June 12, 2024 and July 15, 2024.
  11. Facility Policies Regarding: Assessments, Monitoring of residents, Change in condition, Medication errors. Polices provided to CCLD.
This case management visit was conducted in conjunction with the required annual visit. All deficiencies were addressed and cited on the annual LIC 809-D. Appeal rights were also printed and given to the facility representative at this time. Exit Interview
SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Charlie YangTELEPHONE: (916) 709-6507
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024
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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