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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 04:00:52 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
03/09/2026 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20260309103402
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:
10:28 AM
MET WITH:Randy Morelos TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff did not prevent resident from repeatedly waking another resident
INVESTIGATION FINDINGS:
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On 6-2-2026 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with facility manager Randy Morelos and explained the purpose of the visit. During this investigation, LPA conducted interviews with three residents in care and one staff member. Additionally, LPA reviewed facility file documentation including physician’s reports and needs and services plans.
Allegation: Staff did not prevent resident from repeatedly waking another resident. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that resident2 (R2) has engaged in multiple altercation events of waking up R1, her roommate, in the middle of the night which included achieving close proximity to R1 and banging on her bed. Further interviews conducted revealed that this incident occurred within a two-year period, and an offer was made by facility staff to R1 to move to another room and/or facility, however, this was not a feasible option for R1.

{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-20260309103402
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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This offer was made over one year ago based on interviews conducted, and the above incident continued to occur with staff and Administrator’s awareness. It was further revealed that staff are not assigned at night to monitor R1 and R2’s room despite staff knowledge of the above altercations. Interviews and record reviews additionally revealed that there are no documented efforts to further attempt prevention of the altercations, and to support any staff’s efforts including but not limited to: Additional supervision or consultation attempts.

As a result, there is a preponderance of evidence to conclude that staff have not made a satisfactory attempt to prevent a resident from repeatedly waking another resident, therefore, this allegation is SUBSTANTIATED. A citation 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.
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-20260309103402
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 A
06/03/2026
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, furnishings and equipment. This requirement was not met as evidenced by:
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Licensee will complete and submit a plan outlining steps and procedures for prevention of R2 infringing on the rights of R1 and the engagement of altercations. Plan to include but not be limited to: Supervision options at night, and other documented efforts by staff. Plan to be submitted to LPA by POC due date.
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 Licensee did not secure an adequate prevention plan as an attempt to address an incident in which R2 awoken R1 at night multiple times. This posed an immediate health, safety risk, 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