515002949-5-28-2026-59-AS-TORZ-DVBSN4-20260623140056

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 515002949
Report Date: 05/28/2026
Date Signed: 05/28/2026 01:41:56 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
02/11/2026 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20260211083214

FACILITY NAME:	DELTA AT HOLLY OAKS		FACILITY NUMBER:	515002949
ADMINISTRATOR:	LEONARD WILLIS II		FACILITY TYPE:	735
ADDRESS:	1880 LIVE OAK BLVD		TELEPHONE:	(530) 618-5615
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95991
CAPACITY:	70	CENSUS: 25	DATE:	05/28/2026
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Leonard Willis II		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff do not treat resident with respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Hiratsuka conducted this unannounced complaint visit to deliver the findings of the allegation above. This complaint was received by Community Care Licensing Division (CCLD) in February 2026.

LPA interviewed staff, residents, and witnesses. LPA wasn’t able to interview all the residents. The residents LPA did interview stated they didn’t have any issues. Staff stated they don’t have issues with residents. Witnesses stated there were issues between residents and staff.

Because each side has their own version of events, LPA cannot prove or disprove the allegation above. The allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20260211083214

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: DELTA AT HOLLY OAKS	FACILITY NUMBER: 515002949
	VISIT DATE: 05/28/2026

NARRATIVE

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Based on interviews conducted by the Department and records review, the preponderance of evidence standards has not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026

LIC9099 (FAS) - (06/04)

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