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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397002924
Report Date: 06/02/2026
Date Signed: 06/02/2026 04:05:34 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
05/27/2026 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20260527113312
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: 5DATE:
06/02/2026
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Randy MorelosTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff are not preventing residents from engaging in altercations while in care
Staff are not assisting resident with using wheelchair
INVESTIGATION FINDINGS:
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On 6-2-2026 at 12:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegations noted above. LPA met with facility manager Randy Morelos and explained the purpose of the visit. During this investigation LPA conducted interviews with two staff and two residents in care. LPA also reviewed facility file documentation including physician reports, care notes, and needs and services plan for resident1 (R1) and R2. LPA also conducted a facility observation as part of this investigation.

Allegation: Staff are not preventing residents from engaging in altercations while in care. LPA conducted interviews, facility observation, and record reviews as noted above. Based on interviews, observation, and record reviews, it was revealed that altercations between R1 and R2 have been occurring between one to two years which includes R2 ramming R1's bed with her wheelchair, R2 adjusting television to louder than average volume, and other bullying attempts such as controlling bedroom lights. Interviews further revealed that although facility staff has attempted to assist R2 with relocation, R2 was unable to move and has remained at the facility with the altercation events continuing. {Cont. on 9099C}
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
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 3
Control Number 27-AS-20260527113312
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: 06/02/2026
NARRATIVE
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Interviews further revealed that staff have had knowledge of the altercations, but have not provided necessary supervision or other additional plan to help mitigate or prevent the altercations from occurring. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. A citation has already been issued under complaint #27-AS-20260309103402 on 6-2-2026 which addressed this same violation, therefore, no citation will be issued today.

Allegation: Staff are not assisting resident with using wheelchair. LPA conducted interviews, record reviews, and facility observation as noted above. Based on interviews, observation, and record reviews, it was revealed that R1 has a wheelchair in her bedroom and has previously requested to be out of bed. It was further revealed that R1 is able to tolerate wheelchair use. Additionally, interviews revealed that staff have not consistently approached and attempted to assist R1 to be get out of bed and into her wheelchair. Observation conducted during this investigation revealed R1 in bed with no staff attempt to assist R1 into wheelchair. As a result, there is a preponderance of evidence to conclude that staff are not assisting resident with using a wheelchair, therefore this allegation is SUBSTANTIATED. A citation is issued under Title 22, Division 6, and noted on LIC 9099D.

An exit interview was conducted with facility manager, and a copy of this report was provided. Appeal rights provided. LIC 811 provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260527113312
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: 06/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/12/2026
Section Cited
CCR
87465(a)(2)
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87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility...(2) The licensee shall provide assistance in meeting necessary medical and dental needs...This requirement was not met as evidenced by:
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Licensee will develop and submit a plan to assist R1 with utilizing her wheelchair. Plan to include but not be limited to: Additional staff training for bed to wheelchair transfers. Plan to be submitted to LPA by POC due date.
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Based on interviews and observation, Licensee did not ensure assistance with R1's use of wheelchair. This 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.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3