312701026-9-29-2023-59-AS-KHOS-CW8RHB-20231002130202

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312701026
Report Date: 09/29/2023
Date Signed: 09/29/2023 01:24:26 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, 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
08/14/2023 and conducted by Evaluator Kevin Mknelly

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230814143452

FACILITY NAME:	SILVANA SENIOR CARE 4		FACILITY NUMBER:	312701026
ADMINISTRATOR:	IVASCU, KRISZTINA SILVANA		FACILITY TYPE:	740
ADDRESS:	4738 ROBIN CT		TELEPHONE:	(916) 586-4713
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	6	CENSUS: 5	DATE:	09/29/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Caregivers		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Licensee did not provide comfortable living accommodations and privacy for the staff who resided in the facility

INVESTIGATION FINDINGS:

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On 9/29/23, Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with caregivers to deliver investigation findings. Administrator arrived to assist
LPA reviewed staff records and facility records. LPAs also conducted inspections and conducted interviews.
LPA finds that facility met Tittle 22 requirements.
The staff alleged to have not been provided reasonable living accommodations, no longer work at the facility. Phone contact to one staff was not responded to. An email for another staff mentioned was no longer active. R2, who has continually worked at the home was interviewed.
The Department has conducted various inspections during the time the staff accommodations violations are alleged to have occurred.
Inspections, records and interviews found that when staff have stayed at the facility for non-work times, they have been provided reasonable break and living accommodations.
This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.
Exit interview conducted and report provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin Mknelly	TELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023

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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