Santianna Oakmont Signature Living

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced Case Management visit to follow up on a client death reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Executive Director (ED) Tim Jeffers and Memory Care Director Breanna Santos. Community Care Licensing received an Incident Report on 08/28/26 in which it was reported that a resident (Identified as R1) had passed away on 08/21/26 at a hospice run skilled nursing facility. During today's visit, LPA conducted file review and interviews. The facility is currently awaiting the death certificate once cause of death is officially determined and will forward to the Department once received. At this time, LPA observed no immediate health and/or safety concerns and no deficiencies were cited during today's visit. An exit interview was conducted with ED Jeffers to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Aug 31, 2026

Type of visit: Collateral

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced Collateral visit. LPA was greeted by, identified herself to, and discussed the purpose of the visit with Executive Director Timothy Jeffers. During today's visit, LPA interviewed staff for a complaint investigation filed at a different facility licensed by Community Care Licensing. An exit interview was conducted with Executive Director Timothy Jeffers, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, Mar 16, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management Visit. LPA was greeted by and met with Tim Jeffers, Executive Director, to discuss the purpose of the visit. Today's visit is in response to the self reported incident of Resident 1 who was found unresponsive in their room. LPA conducted a wellness check at the facility and requested records regarding the incident; no health or safety issues were identified. No deficiencies were cited or observed on this date. An exit interview was conducted with Tim Jeffers, Executive Director, who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Dec 4, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management Visit. LPA was greeted by and met with Resident Care Coordinator Mayra Macedo, to discuss the purpose of the visit. Today's visit is in response to the self reported incident of Resident 1 (R1), who alleged that Staff 1 (S1) kicked them. LPA conducted a wellness check at the facility, interviewed staff, residents, and collected facility documents. No health or safety issues were identified. No deficiencies were cited or observed on this date. An exit interview was conducted with Executive Director Tim Jeffers, who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.the state’s words, verbatim · CDSS document, Nov 13, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Nacole Patterson conducted an announced Pre-Licensing visit. LPA was met by applicant Tammie Sampedro and was granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 04/22/2025 and the facility is approved for 226 non-ambulatory residents, eight (8) of which may be bedridden in memory care first and second floors. Delayed egress is approved in the facility's memory care on first and second floor. During today's visit, LPA toured the facility and inspected all common areas, outside spaces, and a sampling of resident rooms across the facility. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Private and common resident bathrooms were observed to be clean and the toilets and showers were found to be in working order. The facility's water temperature in a sampling of resident bathrooms measured between 105-120 degrees Fahrenheit. LPA observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPA observed locked storage for resident medications and files. Fire extinguishers were observed throughout the facility and found to be in compliance. Smoke detectors were observed in the facility to be in working order. The facility has an outdoor pool that was gated and inaccessible to residents. LPA observed 7-day supply of non-perishable food and a 2-day supply of perishable food. Required postings were observed in a common area of the facility. LPA reviewed the applicant's Infection Control Plan and Emergency Disaster Plan. LPA conducted Component III with the applicant. The topics discussed were continuing operation requirements, record keeping/reporting, and physical plant compliance. Pre-licensing is complete, and this facility has no deficiencies. It is recommended that this facility be licensed pending final review and approval. An exit interview was conducted with applicant Tammie Sampedro, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).the state’s words, verbatim · CDSS document, Sep 4, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 225 Census (if any clients in care): COMP II Participants: TAMMIE SAMPEDRO Interview Method: Telephone interview On 8/7/25, administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 7, 2025