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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700263
Report Date: 12/30/2025
Date Signed: 12/30/2025 02:56:36 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
12/24/2025 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20251224120933
FACILITY NAME:PIONEER CARE HOMEFACILITY NUMBER:
392700263
ADMINISTRATOR:RONQUILLO, EUNICEFACILITY TYPE:
735
ADDRESS:9474 PIONEER CIRCLETELEPHONE:
(209) 910-9014
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:6CENSUS: 4DATE:
12/30/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eunice RonquilloTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not afford a resident privacy
INVESTIGATION FINDINGS:
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Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to open a complaint investigation on 12/30/2025 at 2:15pm. LPA met with the administrator to explain the purpose of the visit.

2 residents and 4 staff were interviewed. LPA was shown video taken by a staff of a dementia resident reciving medical attention, admission agreement doesnt have aknowlegement that the resident could be video recorded. Staff taking the video report they felt uneasy about the EMT, recording for the purpose of protecting the licensee from an accusation. Licensee asked the staff to delete the video.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED.

Citation issued on d page, a copy of the report was read and given to the administrator and exit interview was conducted. appeal rights were provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
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
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
12/24/2025 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20251224120933

FACILITY NAME:PIONEER CARE HOMEFACILITY NUMBER:
392700263
ADMINISTRATOR:RONQUILLO, EUNICEFACILITY TYPE:
735
ADDRESS:9474 PIONEER CIRCLETELEPHONE:
(209) 910-9014
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:6CENSUS: 3DATE:
12/30/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eunice RonquilloTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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facility lacks appropriate resident file documentation
Staff are interfering with a resident's medical decisions
INVESTIGATION FINDINGS:
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Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to open a complaint investigation 1030am at 12/30/2025. LPA met with the administrator James Ronquillo and later administrator Eunice Ronquillo to explain the purpose of the visit. the facility is an ARF for serving residents 18-59, 2 clients sub-60 and 2 clients over at this time.

LPA reviewed the client's 602 and the consent forms and staffing schedule. At the time of the incident, the staff provided that their file is substantially complete with a recent medical assessment dated 11/28/2025, and a responsible party contact information, name, birthdate, sex, date of admission,health providers, medical records, funsional assessment, safegaurded cash/property inventory. To the extent that the file was inapproprite, what was handed to the EMT was documentation orginating from another facility, which contained additional information relevant to emergency medical care(medication list).

continued on c page.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 27-AS-20251224120933
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: PIONEER CARE HOME
FACILITY NUMBER: 392700263
VISIT DATE: 12/30/2025
NARRATIVE
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LPA interviewed 4 staff and and 2 residents. consensus statement is ambiguous that staff don't interfere with the medical decisions. it was learned by interview that statements were made by the staff that the EMT did not need medical consent to accept the client into care, the staff provided it was in the context that the emergency nature of the required treatment ought to supersede a concern about liability for a nonconsentting ambulance ride providing, E.g. an unconscious person.

It was learned in interview that Staff were able to get in contact with the appropriate party for giving consent and satisfy the EMT in a timely fashion. Residents report being active participants in their medical decisions and in general.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

no citation issued, appeal rights provided, exit interview conducted.

A copy of the report was read and given to the staff.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 27-AS-20251224120933
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: PIONEER CARE HOME
FACILITY NUMBER: 392700263
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/31/2025
Section Cited
CCR
80072(a)(1)
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80072 (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:
(1) To be accorded dignity in his/her personal relationships with staff and other persons.
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The video was deleted in the presence of the LPA, the licensee is going to schedule a inservice in the next month to review staff/client interactions policy, the LPA will be sent a list of who has attended the training by 1/30/26
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This requirement was not met as evidinced by, being recorded without express, previous permission while reciving emergency medical services, for the purpose of shielding the licensee from potential liability.
This poses a risk to the personal rights of clients 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: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4