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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347005427
Report Date: 11/13/2025
Date Signed: 11/13/2025 01:51:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2025 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20251021131959
FACILITY NAME:OAKMONT OF FOLSOMFACILITY NUMBER:
347005427
ADMINISTRATOR:HILL, ANYSSAFACILITY TYPE:
740
ADDRESS:1574 CREEKSIDE DRTELEPHONE:
(916) 817-4500
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:88CENSUS: 74DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Anyssa Hill, Executive DirectorTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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-Staff are not following refund conditions
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Hood arrived at the care home and met with the Executive Director (ED), Anyssa Hill, to deliver complaint investigation findings regarding the above stated allegation.

During the course of the investigation, LPA conducted interviews and obtained documentation pertinent to the investigation.

ED indicated that the facility was informed of a potential resident (R1) through a placement agency. The facility met with R1 and their responsible party regarding potential move in. According to R1's Admission Agreement, R1's responsible party signed the agreement effective September 2, 2025. On September 6, 2025, R1 refused to move in and following ED offered that the facility could place R1 on the waiting list and refund any monies paid. ED indicated that R1's responsible party declined offer and R1 continued to refuse move in to facility. Interviews with the responsible party and relevant party indicated that they did not provide
*********************************************Continued on LIC9099-C*************************************************
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 59-AS-20251021131959
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: OAKMONT OF FOLSOM
FACILITY NUMBER: 347005427
VISIT DATE: 11/13/2025
NARRATIVE
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the facility with a written 30-day notice when it was determined that R1 did not want to move into the facility. The facility utilized a text message from R1's responsible party indicating that R1 would not be moving in as the official 30-day notice, beginning October 1, 2025. According to R1's Admission Agreement signed September 2, 2025, a resident "may terminate this Agreement at any time, with or without cause, by giving the Executive Director of the Community or his/her designee thirty (30) days' prior written notice of termination. You need not cite a specific reason for the termination. If You move out without providing thirty (30) days notice, You will be responsible for the amount of your Monthly Fee through the date You move plus one full month's fees". ED indicated that, although they didn't receive a formal written notice, they used the text message as notice and informed the responsible party that they will only be responsible for the rent through the 30-days, October 1, 2025- October 30, 2025, and will not be charged an additional months rent. ED indicated that the facility was able to find a new tenant for the apartment to move in October 19, 2025, so offered to prorate what the responsible party owed in rent for October 1, 2025-October 16, 2025. According to ledger, the facility needs to edit their prorating of rent. The facility did not charge R1 care fees and care fees were credited to the account as R1 never received care at the facility. Facility did not charge $500 pet fee as the pet fee of $500 was credited as well.

According to the Admission Agreement, "If you leave Oakmont during the first (1st) month, You will receive a refund of 80% of the Community Fee (minus $500 for the assessment). If you leave Oakmont during the second (2nd) month, You will receive a refund of 60% of the Community Fee (minus the $500 for the assessment)". ED indicated that the facility was going to refund R1 and their responsible party 80% even though R1's move out date was during the second (2nd) month. R1 did not pay rent during the second (2nd) month so had a balance due of $3,852.42.

R1 is due 60% of their Community Fee in the amount of $5,397. Originally, the facility applied the 80% fee towards R1's remaining rent balance due. However, the Community Fee is a separate charge than a resident's rent. The facility agrees to refund R1 the Community Fee. The facility sent R1's responsible party payment of $1,366.60 on November 3, 2025. Text correspondence between facility and responsible party indicated that the check for $1,366.60 was received on November 8, 2025. The facility owes R1 and their responsible party an additional $4,030.40.

Based on records reviewed and interviews conducted, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page.
Exit interview conducted. A copy of report and appeal rights were provided.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
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Control Number 59-AS-20251021131959
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKMONT OF FOLSOM
FACILITY NUMBER: 347005427
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/27/2025
Section Cited
CCR
87507(g)(5)(E)(2)(b)
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87507 Admission Agreements (g) Admission agreements shall specify the following: (5) Refund conditions. (E) Preadmission fees shall be refunded according to the following conditions: 2. Unless Section 87507(g)(5)(E)1. applies, paid preadmission fees that are greater than five hundred dollars ($500) shall be refunded to an applicant, resident, or the applicant/resident’s representative in the following manner: b. A refund of at least 60 percent of the preadmission fee in excess of $500 shall be provided if the resident leaves the facility for any reason during the second month of residency.
This requirement is not met as evidenced by:
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Facility agrees to refund R1 the Community Pre-Admission Fee. Facility will submit a statement of understanding to LPA by the POC due date of 11/27/2025.
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Based on documentation reviewed and interviews conducted, the facility did not refund resident (R1) 60% of their Community Pre-Admission Fee upon moving out of the facility, which poses a potential health, safety, and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
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