415601114-1-10-2024-14-AS-KHOS-CZHP85-20240115100458

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601114
Report Date: 12/14/2023
Date Signed: 01/10/2024 02:23:54 PM

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
12/05/2023 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20231205135135

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: 43	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Interim executive director Jessica Pryor		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

- Staff mismanaged residents' medication
- Untrained staff

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

*** This is an amended document marking the report as public ***

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the above allegation. LPA met with interim executive director Jessica Pryor and explained purpose of today's visit.

During the course of the investigation LPA made observations of the facility medication administration practices, med cart oraganization, reviewed resident medication administration recording process, and reviewed training records. LPA observed that all observed items are in place. LPA asked two med techs to demonstrate their medication handling practices. Medication training for med techs are reviewed as current. 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 Jessica Pryor.

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: 01/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024

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

LIC9099 (FAS) - (06/04)

Page: 1 of 3