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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 01:34:24 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
07/09/2026 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20260709115548
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:
10:15 AM
MET WITH:Randy MorelosTIME COMPLETED:
11:45 PM
ALLEGATION(S):
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Staff do not ensure residents are accorded privacy of other residents
Staff do not prevent residents from disturbing other residents sleep in care
Facility is in disrepair
INVESTIGATION FINDINGS:
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On 9/25/2026 at 10:15am, 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 two residents in care and two staff members. LPA also conducted facility file reviews including physician’s reports and needs and service plans for resident 1 (R1) and R2. Additionally, LPA conducted a facility observation on the dates of 7-16-2026 and 9-10-2026.
Allegation: Staff do not ensure residents are accorded privacy from other residents. LPA conducted interviews and record reviews as noted above. Based on interviews conducted it was revealed that R1 and R2 share a room and live within their designated living spaces. Interviews further revealed that during various periods of times between July and September 2026, R2 interrupted visitations of R1 which included turning the television volume up to uncomfortable levels and ramming her wheelchair towards R1’s guests.

{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 4
Control Number 27-AS-20260709115548
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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 Additional staff interviews revealed that these events occurred. Further investigation revealed that although staff had knowledge of these events, additional measures were not concretely put in place, and no further evidence existed to ensure R1’s privacy. As result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

Allegation: Staff do not prevent residents from disturbing other residents sleep in care. LPA conducted interviews and record reviews as noted above. Based on interviews conducted it was revealed that R1 and R2 share a room and live within their designated living spaces. Interviews further revealed that during various periods of times between July and September 2026, R2 engaged in turning the television volume up to uncomfortable levels during the night and day which caused a disturbance of sleep for R1. Additional staff interviews revealed that these events occurred. Further investigation revealed that although staff had knowledge of these events, additional measures were not concretely put in place, and no further evidence existed to ensure R1’s comfortable accommodation. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

Allegation: Facility is in disrepair. LPA conducted facility observation and staff interviews as noted above. Based on facility observation, it was revealed that a new fire door was installed in room belonging to R1 and R2. An observation conducted by LPA on 7-16-2026 revealed that this door as well as the bathroom door did not close properly and latch. Interviews conducted revealed staff were aware of these disrepair items. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

As a result of this investigation, citations are issued under Title 22, Division 6 and noted on LIC 9099D. An additional civil penalty of $250 issued in addition to citation as a result of a repeat violation of Section 87468.1(a)(2) within a 12—month period. 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 4
Control Number 27-AS-20260709115548
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 A
09/28/2026
Section Cited
CCR
87468.2(a)(1)
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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities. (a) ...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in accommodations…This requirement was not met as evidenced by:
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Licensee will update and submit a staffing plan designed to ensure privacy of residents in care. Plan to include but not be limited to: Appropriate staffing levels.
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Based on interviews, Licensee did not ensure an appropriate level of privacy during R1’s visitations, which posed an immediate health, safety, and resident rights risk to resident in care.
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Type A
09/28/2026
Section Cited
CCR
87468.1(a)(2)
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87468.1 Personal Rights of Residents In All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations…This requirement was not met as evidenced by:
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Licensee to ensure completed staff training on resident rights including but not limited to: Section 87468.1(a)(2). Licensee and designee to also complete training. Training to be completed by an outside vendor. Training date to be submitted to LPA by POC due date, and proof of completed training to be submitted to LPA by 10-9-2026.

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Based on interviews, Licensee did not ensure comfortable accommodations for R1. This posed an immediate health, safety, and resident rights risk to resident 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 4
Control Number 27-AS-20260709115548
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
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times…This requirement was not met as evidenced by:
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Licensee repaired door and LPA observed proper functioning on 9-25-2026.

Licensee and designee to read regulation 87303(a) and submit a signed declaration of understanding to LPA by POC due date.
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Based on observation conducted on 7-16-2026, Licensee did not ensure proper functioning of a bedroom and bathroom door, which posed a potential health, safety, and resident rights risk to resident 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: 4 of 4