312700958-6-1-2023-59-AS-KHOS-CTDKRW-20230703080837

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700958
Report Date: 06/01/2023
Date Signed: 06/01/2023 02:29:58 PM

Unfounded

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
03/28/2023 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20230328164444

FACILITY NAME:	SILVANA SENIOR CARE 2		FACILITY NUMBER:	312700958
ADMINISTRATOR:	MITITI, BIANCA		FACILITY TYPE:	740
ADDRESS:	1245 CRESCENDO DR		TELEPHONE:	(916) 586-4713
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	6	CENSUS: 6	DATE:	06/01/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Krisztina Ivascu, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Residents are chemically restrained with medication
Facility staff not fingerprint-cleared
Staff are using drugs while on duty
Facility staff are abusing residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to continue investigation into allegations listed above. LPA met with administrator Krisztina Ivascu during today's inspection.
LPA investigated allegation, "Residents are chemically restrained with medication". LPA reviewed 6 of 6 resident medications, comparing with physician orders. LPA observed all medications ordered were present at the facility. Administrator stated all medications are dispensed as ordered by the physician and medications are never given to chemically restrain residents. LPA interviewed 2 of 6 residents that were able to be interviewed, and residents reported they are given their correct medications daily. Due to the information gathered LPA finds allegation to be UNFOUNDED.
Continuation on 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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-20230328164444

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 2	FACILITY NUMBER: 312700958
	VISIT DATE: 06/01/2023

NARRATIVE

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LPA investigated allegation, "Facility staff are not fingerprint cleared". LPA reviewed staff files, and reviewed facility association list. LPA observed that all staff are associated to the facility roster, and have valid ID's. Due to information gathered, LPA finds allegation to be unfounded.

LPA investigated allegation, "Staff are using drugs while on duty". LPA interviewed 1 caregiver and conducted a facility tour. LPA did not observe any illegal drugs or evidence of drug use. LPA interviewed caregiver on shift, and caregiver stated they have not used illegal drugs or seen other staff members use illegal drugs. LPA interviewed administrator in which she stated she has not had any staff use illegal drugs while on duty. Due to information gathered LPA finds allegation to be UNFOUNDED.

LPA investigated allegation, "Facility staff are abusing residents". LPA interviewed 1 caregiver and administrator and interviewed 2 residents in care. Residents stated they have not been hurt or abused by staff in any way. Residents reported they feel safe at the facility. LPA interviewed caregiver and administrator in which they stated they have not abused residents in anyway and they have not observed any other staff member abuse residents. Due to the information gathered, LPA finds allegation to be UNFOUNDED.

The allegation is UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC9099 (FAS) - (06/04)

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