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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803998
Report Date: 05/09/2024
Date Signed: 05/09/2024 04:15:40 PM


Document Has Been Signed on 05/09/2024 04:15 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:OAKMONT GARDENSFACILITY NUMBER:
496803998
ADMINISTRATOR:MORGAN HOLIENFACILITY TYPE:
740
ADDRESS:301 WHITE OAK DRIVETELEPHONE:
(707) 921-1861
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY:79CENSUS: 41DATE:
05/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Morgan Holien, AdministratorTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a Case Management and was greeted by Morgan Holien, Administrator.

On 5/8/2024 CCL received from facility a SOC341 report of abuse, type of abuse reported is physical abuse. Suspected abuser is unknown. On 5/1/2024, resident (R1) reported to Health and Wellness Director (HWD) that they were touched under the covers while sleeping. R1 reported that the suspect entered their room, and was touching them under the covers, making them feel uncomfortable. R1 stated they did not know the abuser but thinks the abuser delivers things to their room. R1 reported to HWD that it was not one of the current employees, that they know of, because the current employees do not match the physical description of the suspected abuser. R1 was upset and crying to HWD as they reported the abuse, but claimed the abuser did not sexually assault them. HWD immediately notified Santa Rosa Police Department by calling 911 to report the incident (Event #SR241220238). HWD also reported incident to LTCO.

Per LPA interview with Admin, after HWD called 911 they then notified Admin of R1's report of abuse. While meeting with Admin, HWD received an email from R1's family member. Upon calling R1's family member, HWD was informed that R1 had told the family member that R1 had reported the incident to HWD. R1's family member refused to have the police come out. The police then contacted R1 on 5/2/2024 by telephone to conduct interview. Per Admin, R1 does not have a diagnosis of dementia or MCI, but does occasionally experience some issues with cognitive function.

Per LPA interview with Admin, facility conducted an internal investigation on 5/1/2024 and 5/2/2024 with a subsequent follow up with staff on 5/6/2024. The facility's investigation yielded a finding of unsubstantiated.

LPA confirmed with HWD R1 is now on frequent checks to monitor mental health and overall comfort.

No deficiencies cited during this inspection.

SUPERVISOR'S NAME: Victoria BertozziTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Christi CoppoTELEPHONE: (707) 588-5054
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2024
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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