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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700109
Report Date: 04/23/2026
Date Signed: 04/24/2026 06:26:31 PM

Unsubstantiated


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
11/04/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251104150620
FACILITY NAME:DELTA AT THE SHERWOODSFACILITY NUMBER:
392700109
ADMINISTRATOR:JOSHUA RIVERAFACILITY TYPE:
740
ADDRESS:1215 W SWAIN ROADTELEPHONE:
(209) 689-3180
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:42CENSUS: 29DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:F Khan and Jess SohnTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not assist resident with obtaining medical care in a timely manner
INVESTIGATION FINDINGS:
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On 10/20/25, the Department received a complaint alleging that staff did not respond to Resident 1’s calls for help, that staff were not present on the floor during night or early morning hours, and that R1 experienced delayed medical attention following a reported fall. The complaint also alleged that R1 had experienced similar incidents in the past where staff did not hear or respond to his calls for assistance.

LPA conducted an unannounced visit to the facility, interviewed the Administrator, staff, and residents, including R1 and Resident 2 . LPA also reviewed staff schedules, nightshift supervision procedures, incident reports, and hospital discharge documentation.
Continued
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
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 2
Control Number 27-AS-20251104150620
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 AT THE SHERWOODS
FACILITY NUMBER: 392700109
VISIT DATE: 04/23/2026
NARRATIVE
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Although R1 and R2 reported concerns regarding staff response time, there were no witnesses, no time‑stamped documentation, and no corroborating evidence to confirm that R1 called for help for an extended period without staff response. Staff interviews and facility records indicate staff were present and responded once notified. The allegation that staff failed to supervise residents at night or delayed medical care could not be verified.

Based on interviews, record review, and observations, the allegation is determined to be UNSUBSTANTIATED, Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the alleged violation.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2