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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701272
Report Date: 04/27/2026
Date Signed: 04/27/2026 03:50:49 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
12/11/2025 and conducted by Evaluator Arielle Pascua
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251211142748
FACILITY NAME:OAKMONT OF LODIFACILITY NUMBER:
392701272
ADMINISTRATOR:ARMSTRONG, ANDREAFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(209) 310-1512
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 86DATE:
04/27/2026
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Andrea ArmstrongTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility did not safeguard resident's personal belongings
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 04/27/2026 by Licensing Program Analyst (LPA) Areille Pascua. This LPA was met by the facility designated Administrator, Andrea Armstrong, who was briefly interviewed at this time.

Current census was 86 residents.

This visit was conducted in order to deliver the findings of this investigation to this facility, and its representative, at this time.
Based on a review of the forms and documents that were gathered during the course of this investigation, it was learned that R1 moved into this facility back in the early part of 2023. It was learned that R1 was already diagnosed as being non ambulatory but resided originally in the Assisted Living portion of this facility at that time.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026
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 5
Control Number 27-AS-20251211142748
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: 04/27/2026
NARRATIVE
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It was learned that R1 eventually was diagnosed with dementia and was moved over to the memory care portion, Traditions, of this facility at a later date. This diagnosis was reflected on the LIC 602 that was completed on 02/20/2024.
Based on a review of the forms and documents that were gathered during the course of this investigation, it was learned that this resident, R1, had already lost their dentures from a prior incident that took place earlier in their placement to this facility.
It was learned that there was a second incident that took place where the resident was unable to recall where their dentures were last seen and their family and responsible party were made responsible in replacing them again.
Based on interviews conducted during the course of this investigation, it was learned that the staff were tasked with making sure that proper oral hygiene and care were to be maintained on a daily basis for R1. This task was outlined and implemented on the daily tasks assignment for R1. After the completion of each assigned task, facility personnel would then initial to note that the task had been completed. It was learned that facility staff were unaware as to how the dentures for R1 would have gone missing and did not have a plausible reason at this time.
As a result of this investigation, this LPA found the allegation to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met.
The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.
Appeal rights were printed and a copy was left with the facility designated Administrator at this time.
Exit Interview
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
12/11/2025 and conducted by Evaluator Arielle Pascua
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251211142748

FACILITY NAME:OAKMONT OF LODIFACILITY NUMBER:
392701272
ADMINISTRATOR:ARMSTRONG, ANDREAFACILITY TYPE:
740
ADDRESS:2905 REYNOLDS RANCH PARKWAYTELEPHONE:
(209) 310-1512
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 86DATE:
04/27/2026
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Andrea ArmstrongTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility staff do not assist resident with hygiene needs.
Facility staff do not ensure that resident has clean clothing
Facility staff are not following medication orders
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 04/27/2026 by Licensing Program Analyst (LPA) Areille Pascua. This LPA was met by the facility designated Administrator, Andrea Armstrong, who was briefly interviewed at this time.
Current census was 86 residents.
This visit was conducted in order to deliver the findings of this investigation to this facility, and its representative, at this time.
Based on a review of the forms and documents that were gathered during the course of this investigation, it was learned that R1 moved into this facility back in the early part of 2023. It was learned that R1 was already diagnosed as being non ambulatory but resided originally in the Assisted Living portion of this facility at that time.
It was learned that R1 eventually was diagnosed with dementia and was moved over to the memory care portion, Traditions, of this facility at a later date. This diagnosis was reflected on the LIC 602 that was completed on 02/20/2024.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20251211142748
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: 04/27/2026
NARRATIVE
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Based on a review of the forms and documents that were gathered during the course of this investigation, it was learned that the new pain medication, Hydrocodone, was prescribed and filled on 11/09/2025 when it was dropped off to this facility. This medication was only a PRN and was not to be dispensed on a daily basis but only when the resident, R1, expressed pain and discomfort. It was learned that from 11/09/2025 to when the resident got their staples removed from their back surgery on 11/19/2025, this medication was dispensed a total of 11 times to the resident. Each time this medication was dispensed it was noted and entered into the facility Medication Administration Record (MAR) and charting notes as well.
Based on a review of the forms and documents that were gathered during the course of this investigation, it was learned that there were daily tasks assigned to the facility staff which were to be performed and completed relevant to the care and supervision of R1 on a daily basis. These tasks ranged from toileting, dressing, and assistance with Activities of Daily Living (ADLs). It was observed that these tasks were completed and signed off after their completion by the staff person on duty. These duties spanned over 24 hours for each day and were broken down for each 8 hour shift as well. It was observed that the tasks were clearly signed off by the assigned facility personnel without any missing initials at this time. The months that were reviewed were from the beginning of August 2025 until the end of November 2025.
Based on interviews conducted during the course of this investigation, it was learned that the Memory Care Director had oversight for the daily tasks assigned to the facility personnel and audited these logs on a weekly to a monthly basis to make sure that they were complete and not missing any duties at any given time.
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: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20251211142748
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/11/2026
Section Cited
CCR
87217(b)
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(b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff. The licensee shall give the residents receipts for all such articles or cash resources.
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The facility shall provide this LPA a statement of correction highlighting policies and procedures regarding the safeguarding of resident's property including but not limited to cash resources, personal property and valuables.
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This is not met as evidenced by: Based on interview and record review, the licensee did not ensure that they took the appropriate measures to safeguard the resident's dentures during their admission at the facility. This poses a potential health, safety, and personal rights risks to persons 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: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5