312700676-5-31-2023-59-AS-LMUZ-CSHSWZ-20230605141511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700676
Report Date: 05/31/2023
Date Signed: 05/31/2023 12:53:43 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/25/2023 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20230525110038

FACILITY NAME:	SILVANA SENIOR CARE		FACILITY NUMBER:	312700676
ADMINISTRATOR:	ANDREI DUMITRIU		FACILITY TYPE:	740
ADDRESS:	4748 ROBIN CT		TELEPHONE:	(916) 824-2025
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	6	CENSUS: 5	DATE:	05/31/2023
		UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Administrator, Krisztina Ivascu		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff did not ensure that resident's hygiene needs were met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 05/31/23 to do the complaint investigation for above allegation. LPA met with administrator Krisztina Ivascu and explained the purpose of the visit. LPA wore the following Personal Protective Equipment (PPE) during today's visit-surgical mask. LPA was screened by facility staff upon entry.

The department conducted facility observations and interviews (2 staff and 2 residents) to investigate the complaint.

**Report continued on LIC9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

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-20230525110038

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: SILVANA SENIOR CARE	FACILITY NUMBER: 312700676
	VISIT DATE: 05/31/2023

NARRATIVE

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***continued from LIC9099..........

Allegation- Staff did not ensure that resident's hygiene needs were met.

The department conducted interviews and facility observation to investigate above allegation. During interviews with facility staff and residents, facility is providing appropriate care to the residents according to resident’s needs and service plans. During residents’ (2) interviews on 05/31/23 , residents stated that facility has enough staff and their care needs are met. During 2 staff interviews on 05/31/23 , staff stated that there are enough staff to work at the facility to meet resident’s care needs. Staff and residents interviewed on 05/31/23 indicated that staff were providing incontinence care to residents every 2 hours or as needed per their needs and service plan. Residents interviewed indicated that staff were not leaving them soiled for long times and staff provide assistance for their incontinence care needs as needed. During record review for R1, records indicated that facility did provide all required staffing and assistance to meet R1s care needs. During department visit on 05/31/23, department observed that residents appeared to be well groomed and in good care, 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.

No deficiency was cited during this visit.
Exit interview conducted and copy of this report left with Administrator.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

LIC9099 (FAS) - (06/04)

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