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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803601
Report Date: 11/16/2021
Date Signed: 11/16/2021 01:15:32 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:OAKMONT GARDENSFACILITY NUMBER:
496803601
ADMINISTRATOR:DEL DOSSO, MELISSAFACILITY TYPE:
740
ADDRESS:301 WHITE OAK DRTELEPHONE:
(707) 538-1914
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY:79CENSUS: 115DATE:
11/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Interim Executive Director, Sarah EhretTIME COMPLETED:
01:25 PM
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Licensing Program Analyst (LPA), Erik Gonzalez Campos arrived unannounced to conduct a Required - 1 Year inspection at approximately 11:20 AM, and met with Interim Executive Director Sarah Ehret. The inspection was focused on the Infection Control procedures and practices of this facility. Facility has 36 residents in assisted living and 79 in independent living. Facility has no memory care unit.

Upon entry LPA was screened using an Accushield kiosk . LPA conducted walk through of the facility with Interim Executive Director, COVID postings were observed throughout. Mitigation plan has been submitted and reviewed by Community Care Licensing (CCL). Facility to submit an updated mitigation plan.

Facility was a comfortable temperature and exits were free from obstructions. Hand sanitizer is kept throughout the facility. Staff have completed Personal Protective Equipment (PPE) and infection control training. Staff are not currently fit tested but a plan is place to fit test staff. High touch surface areas are disinfected daily. Residents in assisted living have private apartments and could therefore isolate if necessary. Resident's bathrooms contain necessary grab bars and non-slip floors/mats. LPA confirmed facility has necessary PPE and supplies to support a resident in isolation.

LPA observed cleaning carts with locking mechanisms making toxins inaccessible to residents. Medications were centrally stored in a locked medication room located in the assisted living unit. Residents' emergency contact information has been updated and Interim Executive Director confirmed staff are familiar with 911 procedures and protocols. Facility has a 100% vaccination rate for both staff and clients.

Continued on LIC 809C
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Erik Gonzalez CamposTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: OAKMONT GARDENS
FACILITY NUMBER: 496803601
VISIT DATE: 11/16/2021
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Dining is allowed in the communal dining areas for residents, Common areas allow for social distancing. Visitors are screened and visit primarily in resident apartments. CCL Pins were posted on a bulletin board along with minutes for an active resident council. Activities like puzzles and crafts were observed readily available for residents.

Interim Executive Director informed LPA that administrator S1 left the facility on 10/22/2021. The position is currently vacant but paperwork is to be submitted by the end of the week to assign a permanent administrator

Fire extinguishers are checked monthly.

LPA received updated copy of facility liability insurance.

Exit interview conducted with Interim Executive Director and a copy of the report printed for the facility.

No deficiencies cited during this inspection
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Erik Gonzalez CamposTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
LIC809 (FAS) - (06/04)
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