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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002851
Report Date: 01/24/2024
Date Signed: 01/24/2024 04:01:22 PM


Document Has Been Signed on 01/24/2024 04:01 PM - 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:LIVING AT HOME SENIOR CAREFACILITY NUMBER:
315002851
ADMINISTRATOR:PLOSCEANU, GHEORGHEFACILITY TYPE:
740
ADDRESS:2747 CAMPBELL DRTELEPHONE:
(916) 607-7679
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:6CENSUS: 0DATE:
01/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Gheorghe Plosceanu, LicenseeTIME COMPLETED:
04:15 PM
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On 1/24/24 LPA Tryon arrived at the facility to conduct an annual visit. LPA met with licensee Gheorghe Plosceanu.

The home currently has no clients/residents living at the facility
.
LPA toured the facility including common areas, bedrooms, bathrooms, kitchen, garage, and yard.
The food supplies are adequate, including perishable and non-perishable supplies. The house is clean, well-furnished and in good condition. Rooms are nicely and appropriately furnished.
Locked medication storage present for medications. Cleaners and other potentially hazardous items are stored and locked.
Smoke detectors and carbon monoxide detectors installed, fire extinguisher present and charged,.

LPA reviewed the CARE Tool with licensee.

At this time, the facility appears to be in substantial compliance with regulations. No deficiencies cited.
Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/24/2024
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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