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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601114
Report Date: 12/14/2023
Date Signed: 12/14/2023 03:12:49 PM


Document Has Been Signed on 12/14/2023 03:12 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:OAKMONT OF REDWOOD CITYFACILITY NUMBER:
415601114
ADMINISTRATOR:LAYANA SANTOSFACILITY TYPE:
740
ADDRESS:1 EAST SELBY LANETELEPHONE:
(650) 885-7992
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY:127CENSUS: 43DATE:
12/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Interim executive director Eugenia SmithTIME COMPLETED:
03:30 PM
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On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required 1 year annual inspection visit. LPA met with interim administrator Eugenia Smith and explained the purpose of today's visit.

LPA was allowed entry into the facility and signed in. This is a multi level facility and a memory care building attached. Annual Fees are current upon review. The physical plant was toured inside and outside to ensure the safety of the residents. Patio area outside of memory care building is observed. Fencing and security doors are in good condition and in place. LPA observed the facility kitchen which is clean, in order, and the observed appliances are in good repair. Knives are stored in the kitchen which is not accessible to residents. Cleaning solutions are also locked in multiple janitor closets through out the facility. Perishable and non-perishable food items are observed as in place. LPA observed the medications as in place and locked in med-carts and in med-rooms. First aid kits are observed as complete and placed through out facility including the kitchen. LPA observed that the facility is equipped with full sprinkler system, fire extinguishers are placed through out the facility inspected in October 2023, smoke detectors/carbon monoxide detectors are observed in place, and central heating system is operable. Facility ambient temperature is comfortable for residents and visitors. PPE and additional food supplies are observed as in place. Main laundry room is observed as operational and laundry rooms for use by residents if they choose to wash their own laundry are observed as safe and operational. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Water temperature was measured at 108F in resident rooms in assisted living and memory care. LPA observed several resident rooms at random and all rooms appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. COVID PPE and resident incontinence supplies are observed in place.

The facility does not handle resident monies. Staff and resident files are reviewed and observed as current. The facility is in the process of hiring a permanent administrator.

Report is reviewed with Eugenia. No citations issued.
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2023
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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