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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700940
Report Date: 09/18/2024
Date Signed: 09/18/2024 11:54:05 AM


Document Has Been Signed on 09/18/2024 11:54 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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



FACILITY NAME:LOREDANA CARE HOMEFACILITY NUMBER:
312700940
ADMINISTRATOR:POP, GETA LOREDANAFACILITY TYPE:
740
ADDRESS:1041 AUDREY WAYTELEPHONE:
(916) 841-7065
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:6CENSUS: 6DATE:
09/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Loredana PopTIME COMPLETED:
12:05 PM
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Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced on 9/18/24 to do a case management visit. LPA met with Administrator Loredana Pop and explained the purpose of the visit.

Department followed up on an Incident report that happened on 9/16/24. Incident report and SOC341 was sent to the department on 9/16/24. R1 claimed that a resident (R2) in the facility attempted to rape R1. R1 stated that R2 did rape R1 and that R2 was married with another resident and that they were expecting a baby boy. LPA observed that R2 is a two person assist and that R2 is not able to transfer unassisted. R1 also claimed that someone named “Richard” (no staff member, resident or resident family member or visitor is named Richard) raped R1. When facility notified R1’s responsible party, the responsible party stated that R1 made the same claim against R1’s occupational therapist.

All requested documents relating to this incident were submitted to the department timely.

Interviews conducted.

At this time, this case in under review and department will follow up as needed.

No citations were issued per Title 22 Regulations.

Exit interview conducted and copy of the report left at facility.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Lavinia MuscanTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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