315002859-7-25-2023-59-AS-KHOS-CU9Q2H-20230731114710

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315002859
Report Date: 07/25/2023
Date Signed: 07/25/2023 12:32:29 PM

Unsubstantiated

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
06/23/2023 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20230623084232

FACILITY NAME:	SILVANA SENIOR CARE 5		FACILITY NUMBER:	315002859
ADMINISTRATOR:	SANDOR IVASCU, MIREL		FACILITY TYPE:	740
ADDRESS:	2505 CORIN DR.		TELEPHONE:	(916) 966-8562
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	6	CENSUS: 6	DATE:	07/25/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Krisztina Ivascu, Administrator		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Staff not providing assistance to resident in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to continue investigation into allegation listed above. LPA met with Administrator, Krisztina Ivascu, during today's visit.
During the investigation LPA interviewed residents and staff at the home and completed a file review. LPA interviewed 3 of 6 residents in care. During interviews, two residents stated the staff meet their care needs, and respond in a timely manner. One resident stated at times they have waited long periods of time for staff to respond. LPA interviewed caregiver on duty in which they stated residents do not have to wait long periods of time for care, and staff respond to residents needs in a quick manner. Due to the conflicting information gathered, LPA finds allegation to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated. Exit interview was conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

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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