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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397003771
Report Date: 09/25/2026
Date Signed: 09/25/2026 03:19:09 PM

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
07/06/2026 and conducted by Evaluator Michael Bilger
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260706123932
FACILITY NAME:BROOKDALE LODIFACILITY NUMBER:
397003771
ADMINISTRATOR:MARY MARGARET CHAPPELLFACILITY TYPE:
740
ADDRESS:2220 W. KETTLEMAN LANETELEPHONE:
(209) 367-8870
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY:82CENSUS: 67DATE:
09/25/2026
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Mary Margaret ChappellTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee falsifies documentation regarding residents in care
INVESTIGATION FINDINGS:
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On 9-25-2026 at 3:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced at the facility to deliver and discuss findings for the allegation noted above. LPA met with Administrator Mary Margaret Chappell and explained the purpose of the visit. During this investigation LPA conducted interviews with seven staff members and reviewed facility file documentation including medication log sheets for various residents in care. LPA also conducted a facility observation as part of this investigation.

Allegation: Licensee falsifies documentation regarding residents in care. LPA conducted interviews, record reviews, and observation as noted above. Interviews conducted consisted of staff members from morning, PM, and night shifts. Based on interviews conducted, it was revealed that no corroborated statements existed to confirm or suggest that Licensee has falsified or instructed others to falsify documentation regarding residents in care. Record reviews additionally did not reveal evidence to suggest falsification of documentation regarding residents in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2026
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 2
Control Number 27-AS-20260706123932
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: BROOKDALE LODI
FACILITY NUMBER: 397003771
VISIT DATE: 09/25/2026
NARRATIVE
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An observation conducted by LPA on 9-10-2026 revealed a documentation system consisting of password protected access by staff only. This observation did not reveal any evidence to suggest licensee or other staff falsified documentation regarding residents in care. As a result, the preponderance of evidence standard is not met, and 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 Administrator and a copy of this report was provided. Appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2