392700475-5-15-2025-27-AS-KHOS-DJFLAR-20250710083533

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700475
Report Date: 05/15/2025
Date Signed: 05/15/2025 02:51:08 PM

Substantiated

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
05/13/2025 and conducted by Evaluator Albert Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250513191306

FACILITY NAME:	OAKS AT INGLEWOOD ASSISTED LIVING, THE		FACILITY NUMBER:	392700475
ADMINISTRATOR:	BRITTANY ANDREWS		FACILITY TYPE:	740
ADDRESS:	6725 INGLEWOOD AVE		TELEPHONE:	(209) 957-6257
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	86	CENSUS: 78	DATE:	05/15/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Tha Chay		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff are charging resident for a higher level of care than what is received

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Albert Johnson arrived at facility unannounced to open a complaint investigation into the above listed allegation and deliver findings.

Based on records reviewed and interviews conducted the facility is not following their approved plan of operation. The facility's plan of operation submitted to the department has been amended to include a new level of care description and fees. The facility has implemented this new level of care descriptions and fees without submitting to the licensing agency for approval prior to implementation.

Based on records reviewed and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The facility has been cited for this violation on 5/08/2025 control number 27-AS-20250508090354. Therefore a 9099D pages will not be included in this report. The facility will include this finding into the plan of correction for the complaint dated 5/8/2025. Exit interview conducted and a copy of this report was given with appeal rights.

Substantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

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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