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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 507004970
Report Date: 07/29/2026
Date Signed: 07/31/2026 04:03:27 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
07/06/2026 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260706081051
FACILITY NAME:DELTA STAR - MERCER HOME CAREFACILITY NUMBER:
507004970
ADMINISTRATOR:OSUKA, FESTUS JFACILITY TYPE:
735
ADDRESS:4124 MERCER DRIVETELEPHONE:
(209) 846-9871
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY:6CENSUS: 4DATE:
07/29/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Nicetas "Nessy" RadazaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure air conditioner was fixed timely

Staff did not ensure food was covered properly

Staff did not ensure chemicals were inaccessible to residents

Staff did not ensure that expired food was disposed of

Staff did not ensure toilet paper roll holders were in good working order
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Unannounced complaint visit made out to this facility on 07/29/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Nicetas "Nessy" Radaza. A brief interview was conducted with the facility designated Administrator at this time.
Current census was 4 residents.
The purpose of this visit was to deliver the findings of this complaint investigation to this facility, and it's representative, at this time.
Based on interviews conducted during the course of this investigation, it was learned that facility staff and facility management were unable to determine when a visit was conducted by a representative from the placement agency responsible for the oversight and maintained care for their residents in care. It was learned that this initial visit triggered a follow up visit which then addressed the issue of the facility air conditioning unit not working properly when outside temperatures were reaching high levels for the upcoming holiday weekend. It was learned that facility staff and management were unable to determine the length of time that elapsed from this initial visit to the visit that took place on 07/03/2026 when the air conditioning
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
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-20260706081051
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 STAR - MERCER HOME CARE
FACILITY NUMBER: 507004970
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2026
Section Cited
CCR
80088(a)(1)
1
2
3
4
5
6
7
The licensee shall maintain the temperature in rooms that clients occupy between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C).
The facility was found to be deficient as evidenced by the need for a repair to the
1
2
3
4
5
6
7
The facility designated Administrator stated that all facility staff will always be aware of any visitors that come to this facility with proper notation in the facility notes at all times when dealing with facility physical plant needs that directly affect the residents in care. A statement of correction, along with
8
9
10
11
12
13
14
facility air conditioning unit that needed to be fixed. This facility was unaware of the timeline that was established from the initial discovery of the air conditioning issue to the date that it was actually timely repaired posing an immediate threat to the Health, Safety, and Personal Rights of all residents in care.
8
9
10
11
12
13
14
documented proof of training for no less than (1) hour in duration, on the topic of proper notification and documentation of facility visitors, will be conducted and completed with proof of training submitted into CCL by the due date for review by this LPA.
Type A
07/30/2026
Section Cited
CCR
80076(a)(1)
1
2
3
4
5
6
7
In facilities providing meals to clients, the following shall apply:
(1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the clients. Each meal shall meet at least 1/3 of the servings recommended in the USDA Basic Food Group Plan-Daily Food
1
2
3
4
5
6
7
The facility designated Administrator stated that all foods will be regularly checked and inspected to make sure that they are of good quality and properly stored, with dates, at all times. A statement of correction, along with proof of updated training for no less than (1) hour in duration, on the topics of maintaining
8
9
10
11
12
13
14
Guide for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.
This facility was found to be deficient as evidenced by the presence of expired foods and uncovered foods without proper dates which posed an immediate threat to the Health, Safety, and Personal Rights of all residents in care.
8
9
10
11
12
13
14
standards for handling, preparing and properly storing of all food items for the residents will be completed and submitted into CCL by the due date for review by this LPA.
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: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 27-AS-20260706081051
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 STAR - MERCER HOME CARE
FACILITY NUMBER: 507004970
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2026
Section Cited
CCR
80087(g)
1
2
3
4
5
6
7
Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.
This facility was found to be deficient as evidenced by the presence of cleaning supplies, laundry detergent, and other
1
2
3
4
5
6
7
The facility designated Administrator stated that all cleaning supplies, detergents, and harmful items will be regularly checked and inspected to make sure that they locked and made inaccessible to the residents at all times. A statement of correction, along with documented proof of updated training for no
8
9
10
11
12
13
14
harmful items which were left unlocked and made accessible which posed an immediate threat to the Health, Safety, and Personal Rights of all residents in care.
8
9
10
11
12
13
14
less than (1) hour in duration, on the topic of proper handling and storage of all chemicals and items which pose a threat to the residents if left unlocked, will be completed and submitted into CCL by the due date for review by this LPA.
Type B
08/05/2026
Section Cited
CCR
80087(a)
1
2
3
4
5
6
7
The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.
This facility was found to be deficient as evidenced by the toilet roll holders were broken and in need of repair/replacement which could pose a potential threat to the
1
2
3
4
5
6
7
The facility designated Administrator stated that a review of all facility restrooms utilized by the facility residents will be conducted to make sure that all toilet paper roll holders are in good repair and able to meet the needs of the residents at all times.
A statement of correction, along with proof
8
9
10
11
12
13
14
Health, Safety, and Personal Rights of all residents in care.
8
9
10
11
12
13
14
of repaired/replaced toilet roll holders, will be completed and submitted into CCL by the due date for review by this LPA.
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: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 27-AS-20260706081051
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 STAR - MERCER HOME CARE
FACILITY NUMBER: 507004970
VISIT DATE: 07/29/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
unit was deemed to be lacking and finally contracted and repaired later on that same day. It was learned that the timeline was unable to be established by this facility to make sure that the facility air conditioning unit was maintained and repaired in a timely manner.
Based on interviews conducted during the course of this investigation, it was learned that there was documentation detailing the presence of food items that were expired but still made available for use by this facility. In addition, it was learned that documentation was taken to reveal that food items that were prepared for consumption were not properly covered and stored with appropriate dates on them.
It was learned that there was documentation detailing the presence of laundry supplies, cleaning agents, and other chemicals which were all required to be locked and made inaccessible to the residents in care at all times that were left out and made accessible to the residents in care.
Based on a review of the facility restrooms, it was observed that the toilet paper roll holders were broken and in need of repair/replacement at this time.

As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met.

The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.

Appeal rights were printed and a copy was left with the facility designated Administrator at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4