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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397002924
Report Date: 09/25/2026
Date Signed: 09/25/2026 02:17:56 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
08/13/2026 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20260813124132
FACILITY NAME:DELTA SENIOR CARE HOMEFACILITY NUMBER:
397002924
ADMINISTRATOR:CRIDER,J./ARCAL,A.FACILITY TYPE:
740
ADDRESS:2305 LIDO CIRCLETELEPHONE:
(209) 957-3990
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:6CENSUS: 4DATE:
09/25/2026
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Randy MorelosTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not provide resident with proper notice for rate change
INVESTIGATION FINDINGS:
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On 9-25-2026 at 12:45pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegation noted above. LPA met with house manager Randy Morelos and explained the purpose of the visit. During this investigation, LPA conducted interviews with one resident, one staff member, and one additional witness. Additionally, LPA reviewed facility file documentation including physician’s report, needs and service plan, and rate change notice pertaining to resident1 (R1).
Allegation: Staff did not provide resident with proper notice for rate change. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that a rate change notice was submitted to R1 and R1’s responsible person in June 2026. Based on review of this notice, it was revealed that the rate was to increase by $1000 per month, which equated to a 25% increase.

{Cont. on 9099C}
Substantiated
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 5
Control Number 27-AS-20260813124132
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: DELTA SENIOR CARE HOME
FACILITY NUMBER: 397002924
VISIT DATE: 09/25/2026
NARRATIVE
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This notice was later amended to indicate an increase of $500 per month. The original notice reviewed did not indicate a description of the additional cost for this increase. Furthermore, the notice was presented by the house manager and identified as “Administrator.” The notice did not indicate as being provided by the Licensee. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Health and Safety Codes, and noted on LIC 9099D. An exit interview was conducted with house manager and a copy of this report was provided. Appeal rights and LIC 811 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 5
Control Number 27-AS-20260813124132
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: DELTA SENIOR CARE HOME
FACILITY NUMBER: 397002924
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/05/2026
Section Cited
HSC
1569.655(a)
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H&S Code Section 1569.655 Increase in fee rate for elderly residents, 90 days’ written notice standing amount of reasons for increase…(a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 90 days’ prior written notice to the residents or the residents’ representatives setting forth the amount of the increase and the reason or reasons for the increase, including a description of the additional costs, including a description of the additional costs...This requirement was not met as evidence by:
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Licensee has revised the rate change letter accordingly. Licensee and designee to review regulation Health and Safety Code (H&S Code) Section 1569.655(a) and submit a signed declaration of understanding to LPA by POC due date.
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Based on interview and record review, Licensee did not ensure proper notice of a rate change issued to R1, which posed a potential health, safety, and resident rights risk to residents 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.
SUPERVISOR'S NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

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

DATE: 09/25/2026
LIC9099 (FAS) - (06/04)
Page: 3 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
08/13/2026 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20260813124132

FACILITY NAME:DELTA SENIOR CARE HOMEFACILITY NUMBER:
397002924
ADMINISTRATOR:CRIDER,J./ARCAL,A.FACILITY TYPE:
740
ADDRESS:2305 LIDO CIRCLETELEPHONE:
(209) 957-3990
CITY:STOCKTONSTATE:CAZIP CODE:
95207
CAPACITY:6CENSUS: 4DATE:
09/25/2026
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Randy MorelosTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility staff are not allowing resident to have reasonable accommodations of their preference concerning room choices

Staff threatened resident

Staff are not assisting resident with using wheelchair
INVESTIGATION FINDINGS:
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On 9-25-2026 at 12:45pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegations noted above. LPA met with house manager Randy Morelos and explained the purpose of the visit. During this investigation, LPA conducted interviews with one resident, and one staff member. Additionally, LPA reviewed facility file documentation including physician’s report, needs and service plan, and rate change notice pertaining to resident1 (R1). LPA also conducted a facility observation as part of this investigation.

Allegation: Facility staff are not allowing resident to have reasonable accommodations of their preference concerning room choices. LPA conducted interviews, record reviews, and observation as noted above. Based on interviews conducted, it was revealed that a previous proposal was made by facility’s house manager to move R1 to another room for purposes of attempting to accommodate needs.

{Cont. on 9099C}
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: 4 of 5
Control Number 27-AS-20260813124132
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: DELTA SENIOR CARE HOME
FACILITY NUMBER: 397002924
VISIT DATE: 09/25/2026
NARRATIVE
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It was further revealed that upon observation of the proposed room, it was determined that this room would be a shared room and would not accommodate R1’s bed and other belongings due to its small size. LPA confirmed the size of the room as 10’X10’ and to be too small through observation conducted on 8-19-2026. Interviews and observations also revealed that although the room was offered, R1 was not ultimately moved to the proposed room after requesting to remain in her current room. Additionally, interviews did not reveal corroborated evidence suggesting facility staff did not allow other reasonable accommodations in relation to resident room choices. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff threatened resident. LPA conducted interviews and observation as noted above. This allegation specifically states that facility staff threatened to move R1 to another room regardless of her choice not to move. Based on interviews conducted, a previous proposal was made by facility’s staff manager to move R1 to another room for purposes of accommodating needs. Further interviews revealed that although such a proposal took place, there was no corroborating evidence or statements to confirm that R1 was threatened by house manager or other staff in relation to this proposed room change. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff are not assisting resident with using wheelchair. LPA conducted interviews, record reviews, and observation as noted above. Based on interviews and record reviews, it was revealed that R1 is non-ambulatory and requires assistance with activities of daily living including transfers. Interviews conducted revealed that staff have attempted to transfer R1 to her wheelchair, however, the event has been limited due to R1’s stated complaints of pain when transferring from her wheelchair back to bed. Interviews and record reviews did not reveal corroborating evidence to suggest staff have not assisted resident with using wheelchair. An observation by LPA on 8-19-2026 revealed R1’s wheelchair in place and next to R1’s bed. As a result, there is not a preponderance of evidence to provide staff is not assisting resident with using wheelchair, 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 house manager 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: 5 of 5