435202898-10-4-2024-26-AS-RMAO-DAHRF2-20241029125824

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202898
Report Date: 10/03/2024
Date Signed: 10/04/2024 01:31:22 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2024 and conducted by Evaluator Maria Partoza

COMPLAINT CONTROL NUMBER: 26-AS-20240919142254

FACILITY NAME:	OAKMONT OF SILVER CREEK		FACILITY NUMBER:	435202898
ADMINISTRATOR:	DIAL, JAMES		FACILITY TYPE:	740
ADDRESS:	3544 SAN FELIPE ROAD		TELEPHONE:	(669) 200-2443
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95135
CAPACITY:	148	CENSUS: 64	DATE:	10/03/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Holly Suiter - Exec Director/Administrator		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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A resident sustained multiple falls due to neglect and lack of supervision.
Residents are not accorded with dignity and respect.
Staff are being rough when providing assistance with residents' care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced complaint investigation and met with executive director/administrator (ED/ADM) Holly Suiter and stated the purpose of the visit.

On 9/19/2024, the Department received a complaint alleging that a resident sustained multiple falls due to neglect and lack of supervision, residents are not accorded dignity and respect, staff are being rough when providing assistance with resident's care. On 9/24/2024, the department received additonal complaint and is being address under complaitn number #26-AS-20240924143116. 09/28/2024.

On 9/28/2024, LPA Partoza, conducted an initial investigation and interviewed staff and ED/ADM.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

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 26-AS-20240919142254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: OAKMONT OF SILVER CREEK	FACILITY NUMBER: 435202898
	VISIT DATE: 10/03/2024

NARRATIVE

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A resident sustained multiple falls due to neglect and lack of supervision.
On 9/26/2024, LPA conducted a phone interview with R1s responsible party (RP) and RP stated that R1 does scoot off the bed, tries to get up and thinks that he/she can walk. R1 shakes due to R1s condition.

On 9/28/24, from 9:00 a.m. to 12:00 noon, LPA conducted an interview with 4 staff (S1 to S4). 3 Out of 4 staff states that resident (R1) is non-ambulatory, but always tries to get up or scoots off the bed or slides of the wheelchair. 1 out of 4 helps prop R1, when R1 starts to slides of the wheelchair, but did not see R1 fall of a wheelchair. 3 out of 4 stated that R1 is getting checked every two hours, because of R1s history with fall and wanting to get up, staff increased their supervision by checking on R1 every hour. 3 out of 4 staff stated that after 5 or 15 minutes of being checked R1 will be on the floor again.

Residents are not accorded with dignity and respect.
Based on interview of 4 staff. 4 Out of 4 staff stated that they always respect the resident's personal rights. If they refuse they cannot force the resident. They are free to do what they want and staff supervise or redirect residents. 4 out of 4 stated they care for the resident and they try their best to keep residents active and happy. 4 out of 4 stated they have not seen or witness a resident not accorded with dignity and respect.

Staff are being rough when providing assistance with residents' care.
Based on interview with 4 staff. 3 Out of 4 staff stated, that there was a caregiver before, who got terminated because of abuse that was a year or more ago, and it's been investigated by the Ombudsman. 4 out of 4 stated they have not seen or witnessed a caregiver be rough with the resident after the incident from last year.

Based on document review and interviews, R1 has a condition that contributes to his/her fall due to mental and physical condition and is being addressed on their appraisal needs and services plan.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies are cited during today's visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with ED/ADM Holly Suiter and a copy of the report was provided.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

LIC9099 (FAS) - (06/04)

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