312700676-8-26-2021-25-AS-LMUZ-C6EMY4-20210831100054

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700676
Report Date: 08/26/2021
Date Signed: 08/26/2021 02:46:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/15/2021 and conducted by Evaluator Michael Smith

COMPLAINT CONTROL NUMBER: 25-AS-20210715145031

FACILITY NAME:	SILVANA SENIOR CARE		FACILITY NUMBER:	312700676
ADMINISTRATOR:	KRISZTINA SILVANA IVASCU		FACILITY TYPE:	740
ADDRESS:	4748 ROBIN CT		TELEPHONE:	(916) 586-4713
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	6	CENSUS: 4	DATE:	08/26/2021
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Tomar Reid		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility is in disrepair

INVESTIGATION FINDINGS:

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Prior to entering the facility, LPA Smith spoke with staff to pre-screen that the facility is COVID free. Analyst also self-screened for having no known symptoms or exposure. Analyst followed facility's screening protocols, wore an N-95 respirator and maintained distance during the visit. LPA Smith conducted an unannounced complaint visit and met with Tomar Reid.

LPA conducted the initial 10 day visit and observed a brand new outside air conditioning unit. Licensee stated that the A/C did break and the facility immediately contacted the A/C company to get the non operational A/C working again. Today's visit revealed the A/C was properly working as all of the necessary parts have been replaced.

As a result of this investigation, LPA finds the allegation that facility is in disrepair to be SUBSTANTIATED. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. However, no citation will be issued as mechanical items will eventually wear out, break and need repair. Facility took the immediate and necessary steps to fix the unit.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Michael Smith	TELEPHONE: (916) 208-7807
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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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