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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
415601114
Report Date:
08/16/2023
Date Signed:
08/16/2023 01:41:07 PM
Document Has Been Signed on
08/16/2023 01:41 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
SF COASTAL AC/SC
,
851 TRAEGER AVE., SUITE 360
SAN BRUNO
,
CA
94066
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:
46
DATE:
08/16/2023
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Megan Leone
TIME COMPLETED:
12:00 PM
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On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - incident investigation visit. LPA met with administrator Megan Leone and explained the purpose of the visit. Also in attendance is the memory care coordinator Bernadette King.
LPA discussed the incident that occurred with R1 was unseen and the circumstances are unclear of what actually transpired in terms of a possible fall that may have occurred on 08/15/2023. The facility is within the required reporting time frame to licensing of the incident and the facility is in the process of submitting an incident reporting to the Department. Responsible parties are to be notified on this day according to the administrator.
No citations issued on this day.
SUPERVISOR'S NAME:
Cara Smith
TELEPHONE:
(650) 266-8800
LICENSING EVALUATOR NAME:
Jaime Vado
TELEPHONE:
(559) 476-9353
LICENSING EVALUATOR SIGNATURE:
DATE:
08/16/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/16/2023
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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