312701026-5-20-2022-25-AS-LMUZ-CF9NR4-20220610104051

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312701026
Report Date: 05/20/2022
Date Signed: 05/20/2022 04:47:11 PM

Unfounded

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
03/07/2022 and conducted by Evaluator Talwinder Bains

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220307135328

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: 4	DATE:	05/20/2022
		UNANNOUNCED	TIME BEGAN:	04:16 PM
MET WITH:	Andrei Dumitriu		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Resident's personal rights violated.

INVESTIGATION FINDINGS:

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LPA conducted interviews with residents and staff, reviewed records and conducted several inspections during this investigation.

LPA finds that facility met Title 22 requirements and found no evidence that can prove that residents’ personal rights were violated.

Based on interviews conducted by LPAs with facility residents, staff members and facility tour (03/17/22 and 04/19/22), the above allegation is found to be 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.
We have therefore dismissed the complaint. Exit interview with Administrator.

Unfounded

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: 05/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022

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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