Delta Senior Care Home

Allegation investigated: Staff are not preventing residents from engaging in altercations while in care Staff are not assisting resident with using wheelchair

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 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.the state’s words, verbatim · CDSS document, Jun 2, 2026 · control 27-AS-20260527113312

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(2) · Plan of correction due date: Jun 12, 2026

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: 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.the state’s words, verbatim · CDSS document, Jun 2, 2026

Plan of correction: 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.

Allegation investigated: Staff did not prevent resident from repeatedly waking another resident

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 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.the state’s words, verbatim · CDSS document, Jun 2, 2026 · control 27-AS-20260309103402

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Jun 3, 2026

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: 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.the state’s words, verbatim · CDSS document, Jun 2, 2026

Plan of correction: 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.

Type of visit: Case Management - Other

On 6-2-2026 at 2:58pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management regarding altercations occurring between two residents in care. LPA met with facility manager Randy Morelos and explained the purpose of the visit. During this case management, LPA reviewed interviews conducted and facility file documentation, as well as LPA's observation related to complaint #27-AS-20260527113312. Based on this review, it was determined that resident1 (R1) and R2 have engaged in multiple altercations between one to two years. Additionally, it was determined that despite staff and Administrator knowledge of the altercations, there have not been appropriate attempts to help mitigate or prevent the altercations such as increase in staff supervision or staff check ins with residents to ensure safety. As a result of today's case management, citation is issued under Title 22, Division 6. A copy of this report was provided to facility manager. Appeal rights provided.the state’s words, verbatim · CDSS document, Jun 2, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d)(1) · Plan of correction due date: Jun 12, 2026

87405 Administrator-Qualifications and Duties. (d)The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). (1) Knowledge of the requirements for providing care and supervision appropriate to the residents. This requirement was not as evidenced by: Based on interviews, record reviews, and observations, Licensee did not ensure Administrator initiate appropriate plans to mitigate or prevent known altercations between R1 and R2. This posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 2, 2026

Plan of correction: Licensee and designee will read regulation 87405(d)(1) and submit a signed declaration of understanding to LPA by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst Albert Johnson arrived on 1/06/2026, unannounced to conduct an annual inspection. LPA met with Randy and explained the purpose of the visit. The facility is a RCFE with a current census of 5. The facility has 4 bedrooms and 2 bathrooms. Three bedrooms are being used, one room is empty, but ready for a resident to use. The facility has a formal dining area and a formal living room. LPA conducted the inspection using the CARE tool. LPA and Eva inspected the physical plant including but not limited to the kitchen, bedrooms for residents; two resident bathrooms, laundry area, and backyard area. LPA observed the facility to be free of odor. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 112 degrees Fahrenheit, which is within the required range of 105 to 120 degrees. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications and toxin are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed 5 resident and 2 staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete. No citations, advisories given. Exit interview conducted. A copy of this report was left with the Staff.the state’s words, verbatim · CDSS document, Jan 6, 2026

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Albert Johnson conducted a case management visit on today's date to gather information from the informal meeting conducted on 11/04/2025. LPA Johnson later met with Administrator of record. Certificate expired on 7/25/2018 and 11/102017.During the case management visit, LPA Johnson reviewed facility files and obtained copies of requested information. LPA was able to confirm that an active Administrator is in place with a current certificate. Case management is completed. Technical support has been referred. Exit interview.the state’s words, verbatim · CDSS document, Nov 17, 2025

Type of visit: Office

An informal conference was conducted today in the Sacramento Regional Office. The purpose of this informal conference meeting is to discuss the facility's responsibility in submitting information for a change of ownership and arranging, assisting residents with routine care. Present in the meeting is Licensing Program Manager, Lisa Rios and Licensing Program Analyst, Albert Johnson and Licensees and Administrator Robert Acrai and prospective new licensee Randy Moreno. The informal conference process was explained during this meeting. The licensee was told that this Informal Conference is a part of the Administrative Action process and that further citations may result in an elevation to a formal non-compliance conference that could then lead to referral to the Department's legal division for possible revocation of licensure. Continued Issues discussed during the meeting were: Resident Rights (roommates) / Phone (land line) Routine medical care for residents(toe nails etc..) Licensee/Administrator CHOW application. Property sold July 2025 Technical support The facility has stated they will do the following: Complete an application for a CHOW Provide Liability insurance proof Provide a Lease agreement Secure all medications in locked area or locked cabinet Develop a plan for incidental medical and dental care. Assess compatibility for residents in care. Except technical support. This information shall be submitted to the department by 11/11/2025 The Department did notify the facility that continued Case Management inspections will be conducted to ensure that the facility stays within substantial compliance. LPA will be conducting these visits to ensure that the facilities operation is in compliance and assist the facility in establishing best practices. Exit Interview. Copy of report provided.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Albert Johnson conducted a case management visit to this facility today. LPA toured the facility, LPA Johnson observed an adequate amount of food, as well as the facility at a comfortable temperature, however LPA observed, missing lock for medication, no application for CHOW, construction in the kitchen and bathrooms and floors. LPA Johnson scheduled the informal meeting with the facility for Tuesday, 11/04/25 at 10:30am via teams. If you are unable to keep this appointment and need to reschedule for a different date, please contact me at (916) 217- 1390. Stakeholders have been made aware of this meeting and may or may not choose to attend. Citation given.the state’s words, verbatim · CDSS document, Oct 15, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Oct 16, 2025

Incidental Medical and Dental Care Services. Centrally stored medications shall be kept in a safe locked place that is not accessible to persons other than employees responsible for the supervision of the medication. his requirement was not met as evidencied by observation during the tour LPA observed medications in residents rooms and unlocked in the living room cabinet This is an immediate risk to residents in care.the state’s words, verbatim · CDSS document, Oct 15, 2025

Plan of correction: Administrator shall secure all medications in locked area or locked cabinet by close of business of POC date.

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct a case management visit. LPA met with Charito De Los Reyes to discuss change of ownership. Later joined by the Administrator. The facility has submitted the required documentation to change ownership. LPA confirmed that the facility is in process to change ownership. Exit interview conducted.the state’s words, verbatim · CDSS document, Sep 3, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct a case management visit. LPA met with Charito De Los Reyes to discuss change of ownership. The facility has not submitted the required documentation to change ownership. LPA provide the facility with information to complete the process to change ownership. LPA toured the facility. During the facility visit LPA observed multiple issues with the facility. The medication administration record is not up to date and medications are missing for R1 and R2, Staff (S1) working today is not associated to this facility , S1 is missing first aid CPR certification and R2 need to have an updated physician's report (Lic 602) R2 stated that she is bedridden and she doe not get up to go to the bathroom or have a wheelchair or walker. Informal meeting will be schedule to address the above concerns. Deficiencies were cited during today's visit. Civil penalties assessed. Exit interview conducted.the state’s words, verbatim · CDSS document, Aug 27, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(5) · Plan of correction due date: Aug 28, 2025

87465 Incidental Medical and Dental Care Services. (a) A plan for incidental medical and dental care shall be developed by each facility. (5) the licensee shall assist residents with self administered medications as needed. this requirement is not met as evidenced by: Based on LPA's observation R1 and R2 are missing medication which poses an immediate potential risk to resident's in care.the state’s words, verbatim · CDSS document, Aug 27, 2025

Plan of correction: Administrator agrees to obtain all missing medications for R1 and R2. Licensee to send in a copy of the centrally stored medication record, indicating missing medications are available. By POC date 8/28/2025.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(e)(1) · Plan of correction due date: Aug 28, 2025

Criminal Record Clearance. Prior to working, residing or volunteering in a licensed facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement is not met as evidenced by: interviews and records review, S1 is not associated to this facility This poses and immediate health and safety risk to residents.the state’s words, verbatim · CDSS document, Aug 27, 2025

Plan of correction: Licensee will immediately ensure (S1) is finger print cleared and associated to facility prior to HER reporting to work. Proof of clearance and association shall be submitted to CCL prior to resuming duties. Administrator shall submit a Statement of Understanding regarding the requirements by POC date via email to CCL.IMMEDIATE CIVIL PENALTY ASSESSED

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c)(1) · Plan of correction due date: Aug 27, 2025

87411-Personnel Requirements - General-Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. LPA observed no first aid certification For S1. Based on this, facility is in violation of this section.the state’s words, verbatim · CDSS document, Aug 27, 2025

Plan of correction: Identified individual shall obtain a current valid first aid certification. This shall be done within 1 day. Facility shall forward a copy to the LPA to clear this deficiency.

Type of visit: Required - 1 Year

Licensing Program Analyst Albert Johnson arrived on 1/09/2025, unannounced to conduct an annual inspection. LPA met with Eva Gahob and explained the purpose of the visit. The facility is a RCFE with a current census of 5. The facility has 4 bedrooms and 2 bathrooms. Three bedrooms are being used, one room is empty, but ready for a resident to use. The facility has a formal dining area and a formal living room. LPA conducted the inspection using the CARE tool. LPA and Eva inspected the physical plant including but not limited to the kitchen, bedrooms for residents; two resident bathrooms, laundry area, and backyard area. LPA observed the facility to be free of odor. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 112 degrees Fahrenheit, which is within the required range of 105 to 120 degrees. Fire extinguishers (Dated 9/7/24) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications (Locked in the kitchen cabinets) and toxin are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed 6 resident and 2 staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete. No citations, advisories given. Exit interview conducted. A copy of this report was left with the Staff.the state’s words, verbatim · CDSS document, Jan 9, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst Albert Johnson arrived on 1/25/2024, unannounced to conduct an annual inspection. LPA met with Eva Gahob and explained the purpose of the visit. Later joined by Robert Arcal. The facility is a RCFE with a current census of 5. The facility has 4 bedrooms and 2 bathrooms. Three bedrooms are being used, one room is empty, but ready for a resident to use. The facility has a formal dining area and a formal living room. LPA conducted the inspection using the CARE tool. LPA and Eva inspected the physical plant including but not limited to the kitchen, bedrooms for residents; two resident bathrooms, laundry area, and backyard area. LPA observed the facility to be free of odor. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 112 degrees Fahrenheit, which is within the required range of 105 to 120 degrees. Fire extinguishers (Dated 9/7/23) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications (Locked in the kitchen cabinets) and toxin are kept locked and inaccessible to residents. LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed 5 resident and 2 staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete. No citations given. Exit interview conducted. A copy of this report was left with the Staff.the state’s words, verbatim · CDSS document, Jan 25, 2024