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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700412
Report Date: 07/02/2025
Date Signed: 07/02/2025 03:15:33 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
04/16/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20250416093318
FACILITY NAME:CHIANTI JOY LLCFACILITY NUMBER:
392700412
ADMINISTRATOR:MORELOS, RANDY SFACILITY TYPE:
740
ADDRESS:9152 CHIANTI CIRTELEPHONE:
(209) 242-2006
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:6CENSUS: 5DATE:
07/02/2025
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Randy MorelosTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not abide by the admission agreement
INVESTIGATION FINDINGS:
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On 7-2-2025 at 1:50pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with Administrator Randy Morelos and explained the purpose of the visit. During this investigation, LPA conducted interviews with staff1 (S1) and reviewed facility file documentation including physician’s report, admissions agreement, medication log sheets, preplacement appraisals for resident1 (R1) and R2, and additional documentation provided via text messages. Based on interviews and record reviews, it was revealed that R1 and R2 were admitted to facility on or about 3-14-25. R1 entered facility has a hospice recipient and requiring full assistance with ADLs according to physician’s report and pre-placement appraisal reviewed. Interviews and record reviews conducted revealed that on 4-15-2025, Licensee informed R1 and R2’s responsible party of a new rate change should they remain in facility for the following month.

{Cont. on 9099C}
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025
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 5
Control Number 27-AS-20250416093318
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: CHIANTI JOY LLC
FACILITY NUMBER: 392700412
VISIT DATE: 07/02/2025
NARRATIVE
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 Interviews further revealed that this rate change was proposed to raise from $6000 to $8000 and up to $9000 for both R1 and R2. Additionally, it was determined through interview that Licensee did not provide a formal written notice of a rate increase for level of care per regulatory requirements.

As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Health and Safety Codes, Chapter 3.2, and noted on LIC 9099D. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided. LIC 811 provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 27-AS-20250416093318
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: CHIANTI JOY LLC
FACILITY NUMBER: 392700412
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/14/2025
Section Cited
HSC
1569.657(a)
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1569.657 Rate increase due to change in level of resident care; notice. (a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative, if any, written notice of the rate…The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges. This requirement was not met as evidenced by:
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Licensee will read regulation 1569.657(a) and provide a written declaration of understanding to LPA by POC due date.
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Based on interview and record review, Licensee did not ensure a proper notice for a level of care rate increase to R1 and R2 per regulatory requirements. This posed a potential health, safety, and resident rights risk to resident 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: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
04/16/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20250416093318

FACILITY NAME:CHIANTI JOY LLCFACILITY NUMBER:
392700412
ADMINISTRATOR:MORELOS, RANDY SFACILITY TYPE:
740
ADDRESS:9152 CHIANTI CIRTELEPHONE:
(209) 242-2006
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:6CENSUS: 5DATE:
07/02/2025
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Randy MorelosTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee has insufficient staffing to meet resident needs
Licensee does not ensure safe, healthful, and comfortable accommodations for residents
Staff made inappropriate comments about a resident
INVESTIGATION FINDINGS:
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On 7-2-2025 at 1:50pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegation noted above. LPA met with Administrator Randy Morelos and explained the purpose of the visit. During this investigation, LPA conducted interviews with three staff members and 4 residents in care. Additionally, LPA reviewed facility file documentation including physician’s report, admissions agreement, medication log sheets, preplacement appraisals for resident1 (R1) and R2, and additional documentation provided via text messages. LPA conducted facility observations on 4-17-2025 and 4-28-2025.
Allegation: Licensee has insufficient staffing to meet resident needs. LPA conducted interviews, record reviews, and observations as noted above. Based on interviews and observation, it was revealed that at least two staff members are on duty consistently to assist resident with their needs with a census of 6. Interviews conducted did not reveal any corroborated evidence or statements that staff is not meeting resident needs.

{Cont. on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20250416093318
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: CHIANTI JOY LLC
FACILITY NUMBER: 392700412
VISIT DATE: 07/02/2025
NARRATIVE
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Observations conducted revealed staff attending to various needs of residents in care including assistance with activities of daily living, toileting, medications, and meal assistance. Additionally, observations revealed staff checking on resident approximately every hour to ensure needs met. As a result, there is a not a preponderance of evidence to conclude licensee is not providing sufficient staffing to meet resident needs, therefore, this allegation is UNSUBSTANTIATED.

Allegation: Licensee does not ensure safe, healthful, and comfortable accommodations for residents. LPA conducted interviews, record reviews, and observations as noted above. Based on interviews and observation, it was revealed facility staff provides required accommodations including necessary bedroom furniture and other furnishing throughout the facility. Additionally, it was revealed that facility maintains the securing of medications, sharp objects, and other dangerous items. LPA observed water pitcher for R1 in place and staff assisting R1 with obtaining water. Appropriate bed linen was noted in place on all beds as well as a storage for additional supply. Additional interviews conducted did not reveal any corroborated statements or evidence regarding lack of safe, healthful, and comfortable accommodations for residents. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff made inappropriate comments about a resident. LPA conducted interviews, record reviews, and observations as noted above. Based on record reviews and observation, there was no evidence revealed that staff made inappropriate comments about a resident. Interviews conducted with staff and residents did not reveal corroborated statements or other evidence to conclude staff made inappropriate comments about a resident. Observations conducted did not reveal inappropriate comments made by staff to residents. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5