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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700244
Report Date: 04/04/2024
Date Signed: 04/04/2024 10:47:02 AM


Document Has Been Signed on 04/04/2024 10:47 AM - 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:SPRING VIEW GARDENS CARE HOMEFACILITY NUMBER:
342700244
ADMINISTRATOR:TAFTA, DANIELFACILITY TYPE:
740
ADDRESS:9964 SPRING VIEW WAYTELEPHONE:
(916) 273-2175
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY:6CENSUS: 4DATE:
04/04/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Daniel Tafta, Mihaela TaftaTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct an annual inspection. LPA met with facility staff, and explained the purpose of the visit. LPA was then met by Licensee/Administrators Mihaela and Daniel Tafta.

LPA Valerio and Licensee Mihaela toured the facility to ensure compliance with Title 22 regulations. LPA inspected resident bedrooms, resident bathrooms, the living room, dinning room, kitchen area, garage, and exterior area. Resident bedrooms were observed to be clean and free from debris. The rooms were fully furnished and free from odors. No emergency exits were obstructed. Resident bathrooms were observed to have skid mats, hand rails, paper towels, toilet paper, soap, hand sanitizer, and a trash can. Common areas were observed to be clean and organized. The facility was observed to meet the requirements of 2-day perishable food items and 7-day nonperishable food items. The backyard has shaded areas for visiting or outdoor activities. Sheds in the backyard are being utilized for storage. No emergency exits were obstructed. LPA observed medications, toxins, and sharps to be locked away and inaccessible to residents in care. Fire extinguisher, carbon dioxide detector, and fire alarms appeared to be in working condition. LPA observed the temperature inside the home to be 74* degrees, which is within the required regulatory range. During the visit, residents were observed in their room sleeping, in their room listening to music and using electronics, in the common area watching television, and getting visit from an outside agency. Staff were assisting residents, cleaning after breakfast, preparing lunch, and cleaning around the facility. LPA spoke to staff and residents during the tour.

LPA Valerio reviewed 2 resident files and 2 staff files. All files were observed to be up to date with required documents. The last emergency drill was conducted on 03/12/2024. LPA obtained annual required documentation for the RO facility file: Administrator Certificate, LIC 308, Liability Insurance, LIC 610, and confirmation of FIT test.

Per California Code of Regulations (CCR) - Title 22, no deficiencies were observed during today's visit. An exit interview was held, and a copy of the report was provided.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024
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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