<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502701322
Report Date: 07/23/2026
Date Signed: 07/23/2026 03:33:29 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
05/06/2026 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20260506104525
FACILITY NAME:RENAISSANCE CARE HOME INCFACILITY NUMBER:
502701322
ADMINISTRATOR:RANIN, TERESITA N.FACILITY TYPE:
740
ADDRESS:812 NORWEGIAN AVENUETELEPHONE:
(209) 408-8439
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:6CENSUS: 5DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Terissita RaninTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not provide resident with required notice of fee increase

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to conduct a complaint investigation into the above allegations, LPA met with administrator Teresita Ranin to explain the purpose of the visit.
LPA was given a copy of the admission agreement, it does include modification conditions requiring 60 days notice for a rate change for basic services. The Administrator explained in interview a client had a increase in Febuary of 2026 (resident moved to a privite room) without written notice, and a rate increase from september of 2025 (resident had increases in care) without a written notice. The notice was given and agreed to verbally, and signed on the admission agreement but not 60 days in advance of the change and not written.
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. California Code of Regulations, is being cited on the attached LIC 9099D.
A copy of the report was read and given to the administrator. appeal rights were provided, exit interview was conducted
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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 4
Control Number 27-AS-20260506104525
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: RENAISSANCE CARE HOME INC
FACILITY NUMBER: 502701322
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/06/2026
Section Cited
CCR
87507(g)(4)
1
2
3
4
5
6
7
87507 Admission Agreements (g) Admission agreements shall specify the following:(4) Modification conditions, including the requirement for the provision of at least 60 days prior written notice to the resident of any rate or rate structure change, or as soon as the licensee is notified,
1
2
3
4
5
6
7
LPA is suggesting those terms are added if they are not there, to the admission agreement in a modification conditions ammendium by the poc date, 8.06.26
8
9
10
11
12
13
14
This requirement was not followed as evidniced by: Record review of admission agreement were 60 days written notice prior to rate change terms are present, Interview with administrator where she is saying the notice is verbal and not 60 days in advance.

not following this requirement poses a health, saftey, personal rights risk to clients in care
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 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
05/06/2026 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20260506104525

FACILITY NAME:RENAISSANCE CARE HOME INCFACILITY NUMBER:
502701322
ADMINISTRATOR:RANIN, TERESITA N.FACILITY TYPE:
740
ADDRESS:812 NORWEGIAN AVENUETELEPHONE:
(209) 408-8439
CITY:MODESTOSTATE:CAZIP CODE:
95350
CAPACITY:6CENSUS: DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Terissita RaninTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are unable to communicate with residents due to a language barrier
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to conduct a complaint investigation into the above allegations, LPA met with administrator Teresita Nanin to explain the purpose of the visit.

It was learned in interview of the 4 staff employees on the LIC 500 shift schedules, 2 were able to communicate in well english and 2 are shaky. T22 regulations outline that at least one staff on each shift should be able to communicate effectively with emergency services. LPA gave guidance that the two that are not should not work on the same shift together, and staff should be instructed to get assistance from thier english speaking coworker or the administrator when in a situation where something is being miscommunicated.

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. A copy of the report was read and given to staff, exit interview was conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4