392701057-4-24-2026-27-AS-LKIG-DTZSBB-20260512134337

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701057
Report Date: 04/24/2026
Date Signed: 04/24/2026 11:42:04 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
02/02/2026 and conducted by Evaluator Michael Bilger

COMPLAINT CONTROL NUMBER: 27-AS-20260202215253

FACILITY NAME:	OAKMONT OF BROOKSIDE		FACILITY NUMBER:	392701057
ADMINISTRATOR:	TRACY BURKE		FACILITY TYPE:	740
ADDRESS:	3318 BROOKSIDE ROAD		TELEPHONE:	(209) 473-1300
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY:	81	CENSUS: 78	DATE:	04/24/2026
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Tracy Burke		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not keep the facility clean and sanitary
Staff is providing resident unauthorized medication
Staff did not keep resident's authorized person informed regarding resident's care

INVESTIGATION FINDINGS:

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On 4-24-2026 at 10:30am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegations noted above. LPA met with Executive Director Tracy Burke and explained the purpose of the visit. During this investigation, LPA conducted interviews with two staff members and one resident in care. Additionally, LPA reviewed facility file documentation including medication log sheets and physician orders, care notes, admissions agreement, individual service plan, and various email communications pertaining to this investigation. Additionally, LPA conducted a facility observation on 2-5-2026

Allegation: Staff did not keep the facility clean and sanitary. LPA conducted interviews and facility observations as noted above. Observations conducted included various resident rooms, common areas, and bathrooms within memory care and assisted living units. Based on these observations, facility was found to be clean and sanitary throughout including the bathroom areas.

{Cont. on 9099C}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

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 27-AS-20260202215253

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 BROOKSIDE	FACILITY NUMBER: 392701057
	VISIT DATE: 04/24/2026

NARRATIVE

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Assigned staff were on duty and observed to be meeting the needs of residents in care. Interviews conducted did not reveal any corroborated statements of facility kept unclean or unsanitary. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff is providing resident unauthorized medication. LPA conducted interviews and record reviews as noted above. Based on review of care notes pertaining to resident1 (R1), it was revealed that medication Hydroxyzine HCL 25mg was given to R1 per physician’s orders which state: “Take 1 tab by mouth every 6 hours as needed for agitation.” Additionally, a review of facility care notes revealed communication between facility staff and responsible person for R1 regarding the use of the above medication which included a request by responsible person on 1-11-2026 to provide this medication due to R1 experiencing an agitated episode. Interviews conducted also confirm the above. As a result, there is not a preponderance of evidence to conclude staff has provided unauthorized medication to a resident. As a result, this allegation is UNSUBSTANTIATED.

Allegation: Staff did not keep resident’s authorized person informed regarding resident’s care. LPA conducted interviews and record reviews as noted above. Based on review of care notes and email communications, it was revealed that various communications between staff and responsible party for R1 took place during January 2026 which included medication use and contents of R1’s care plan. Specifically, on 1-20-2026, care notes revealed that a care conference was conducted between facility staff and R1’s responsible persons which resulted in an adjustment to R1’s care plan and the addition of hands-on services. A review of email communication dated 1-21-2026 revealed a follow up email to R1’s responsible person to confirm the additional services to be added to R1’s care plan. The email also stated that no additional costs are to be imposed for this change at that time. Interviews conducted also confirm the above. As a result, there is not a preponderance of evidence to conclude that staff has not kept resident’s authorized person informed regarding resident’s care, therefore, this allegation is UNSUBSTANTIATED.

A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.
An exit interview was conducted with Executive Director, and a copy of this report was provided. Appeal rights provided.

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026

LIC9099 (FAS) - (06/04)

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