392701272-12-13-2024-27-AS-KHOS-DCXPLR-20250115102511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701272
Report Date: 12/12/2024
Date Signed: 12/13/2024 08:34:59 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
10/08/2024 and conducted by Evaluator Charlie Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20241008143051

FACILITY NAME:	OAKMONT OF LODI		FACILITY NUMBER:	392701272
ADMINISTRATOR:	ARMSTRONG, ANDREA		FACILITY TYPE:	740
ADDRESS:	2905 REYNOLDS RANCH PARKWAY		TELEPHONE:	(209) 310-1512
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	136	CENSUS: 93	DATE:	12/12/2024
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Andrea Armstrong		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee does not ensure enough staff are present to prevent inappropriate interaction between residents.

INVESTIGATION FINDINGS:

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

Unannounced complaint visit made out to this facility on 12/12/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Andrea Armstrong.
A brief interview was conducted with the facility designated Administrator at this time.
Current census was 93 residents.
The purpose of this complaint visit was to complete this investigation and present the findings to this facility, and its representative, at this time.
Based on interviews conducted and a review of the forms and documents that were received during the course of this investigation, it was learned that R1 and R2 were both facility residents who were placed in the Memory Care Unit of this facility.
It was learned that these residents were mainly diagnosed with some form of cognitive impairment by their licensed medical professionals. It was learned that these residents would often roam the memory care unit or pace the hallways without any particular purpose in mind. It was learned that other residents would not be able to recall certain memories from their life and would sometimes mistaken other residents for their family

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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 2

Control Number 27-AS-20241008143051

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKMONT OF LODI	FACILITY NUMBER: 392701272
	VISIT DATE: 12/12/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

members or even loved ones at times.
It was learned that some residents would even seek out other residents for comfort and support even though they had no familial ties or any past history with one another.
It was learned that such was the case involving R1 and R2 in terms of seeking each other out and seeking comfort as well.
It was learned that it was not a forced relationship and that they would even miss or look out for one another when one of them was not present.
It was learned that both, R1 and R2, would make the initial attempt to hold each others hand when they initially spotted each other after a brief separation. It was learned that this was not a one-sided relationship where one individual was taking advantage of the other due to cognitive decline.

As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

There were no deficiencies observed or cited at this time.

Exit Interview

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2