415601114-5-10-2024-14-AS-ACON-D5QLKK-20240529084937

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601114
Report Date: 05/10/2024
Date Signed: 05/10/2024 11:18:01 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/07/2023 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20230807085356

FACILITY NAME:	OAKMONT OF REDWOOD CITY		FACILITY NUMBER:	415601114
ADMINISTRATOR:	LAYANA SANTOS		FACILITY TYPE:	740
ADDRESS:	1 EAST SELBY LANE		TELEPHONE:	(650) 885-7992
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94063
CAPACITY:	127	CENSUS: 60	DATE:	05/10/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Administrator - Siobhan Surraco		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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- Staff lock residents in their room
- Residents eloped from the facility
- Staff did not report unusual incident to resident's representative
- Staff did not feed resident in care
- Staff did not dress resident in care
- Staff not provide resident with hygiene needs

INVESTIGATION FINDINGS:

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On 05/10/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver the findings regarding the allegations received. LPA met with administrator Siobhan Surraco and explained the purpose of today's visit.

During the investigation LPA conducted interviews and made observations. Interviews with staff, and a tour of resident rooms, show that the rooms are able to be unlocked from the inside by just turning the door handle. The locking mechanism is on the inside and can be unlocked from the outside via room key. LPA and administrator was able to unlock the residents room with a key as a demonstration and the resident inside locked the door themself after it was unlocked and announced entrance to the room. Interviews with staff do contradict with the allegation that residents are being locked in their rooms intentionally.

Continued on next page...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime Vado	TELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 14-AS-20230807085356

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: OAKMONT OF REDWOOD CITY	FACILITY NUMBER: 415601114
	VISIT DATE: 05/10/2024

NARRATIVE

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Page 2 - LIC9099C

Regarding elopements from the facility, LPA cannot determine if this took place based on information received regarding these alleged incidents. There is not enough information and support to show that residents in fact eloped based on staff, video, and family interviews conducted. At the time of the alleged elopements those original staff that were in place, including memory care directors, are no longer present and cannot be contacted. No elopements were reported to management in order to report an incident to the Department. LPA cannot determine if incident reporting took place for the elopements in question. Regarding staff not feeding, dressing, or providing hygiene needs for residents. LPA conducted interviews and made facility observations. Interviews with staff show that the resident in question regarding not feeding or dressing a resident contradict with complainant information and interviews conducted. It was indicated by staff that the residents have the freedom of choice of getting dressed when getting ready in the morning. The resident in question refused to get ready in the morning and staff can not force a resident to change or do something they do not want to do as it will be against their personal rights. For the same resident LPA cannot determine if the was fed on time as the resident was refusing morning care that morning and staff were turned away by the resident and staff intended on returning to the resident to follow up with morning care and feeding. Regarding staff not providing hygiene needs, LPA toured resident rooms that are occupied and observed toilet paper in place. The resident in question is no longer at the facility at the time of investigation to observe if toilet paper was present. Staff interviewed indicate that if there was no toilet paper it would be provided if needed. Staff do replenish toilet paper everyday and when needed. Based on interviews, observations, and other items reviewed, LPA cannot determine if these allegations took place. These allegations are unsubstantiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time. Report is reviewed with the administrator Siobahn Surraco and a copy of the report is provided.

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime Vado	TELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

LIC9099 (FAS) - (06/04)

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