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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700475
Report Date: 12/15/2025
Date Signed: 12/15/2025 11:32:54 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
09/08/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250908122642
FACILITY NAME:OAKS AT INGLEWOOD ASSISTED LIVING, THEFACILITY NUMBER:
392700475
ADMINISTRATOR:BRITTANY ANDREWSFACILITY TYPE:
740
ADDRESS:6725 INGLEWOOD AVETELEPHONE:
(209) 957-6257
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:86CENSUS: 78DATE:
12/15/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Tha ChayTIME COMPLETED:
11:56 AM
ALLEGATION(S):
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Staff did not ensure the facility fire alarm was not in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Albert Johnson arrived at facility unannounced to deliver findings for the above listed allegation.

After reviewing records and conducting inspections, we found that the facility promptly addressed the issue with the alarm system. The necessary repairs were completed, and after a thorough inspection, the system was cleared as safe for residents. As part of the service request, the facility was required to temporarily disable the smoke detector located in the main hall on the second floor. During this period, a safe alternative was provided to ensure continued protection for all residents until the replacement detector was installed.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025
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-20250908122642
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: OAKS AT INGLEWOOD ASSISTED LIVING, THE
FACILITY NUMBER: 392700475
VISIT DATE: 12/15/2025
NARRATIVE
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Documentation, including service records and invoices, confirmed that the alarm system was not in disrepair at any point. The system is maintained annually, and the most recent inspection panel displayed current fire clearance tags.

As a result, there is not a preponderance of evidence to conclude that Staff did not ensure the facility fire alarm was not in disrepair, therefore this allegation is UNSUBSTANTIATED.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2