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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700929
Report Date: 09/25/2024
Date Signed: 09/25/2024 12:48:55 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
09/18/2024 and conducted by Evaluator Michael Hood
COMPLAINT CONTROL NUMBER: 59-AS-20240918140226
FACILITY NAME:ALL SEASONS HIALEAHFACILITY NUMBER:
342700929
ADMINISTRATOR:TOLY MOLITVENIKFACILITY TYPE:
740
ADDRESS:8407 HIALEAH WAYTELEPHONE:
(916) 776-6665
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 5DATE:
09/25/2024
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Galina Chikivchuk, Operations DirectorTIME COMPLETED:
01:05 PM
ALLEGATION(S):
1
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9
Licensee does not ensure staff are able to communicate with residents in care
INVESTIGATION FINDINGS:
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9
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13
Licensing Program Analysts (LPAs) Michael Hood and Cassie Mikkelson arrived at the facility and met with Operations Director (OD), Galina Chikivchuk, to open a complaint investigation into the allegation listed above.

During today's visit, LPAs conducted interviews, toured the facility, and review documentation pertinent to the investigation.

LPAs toured the facility during inspection and observed all residents receiving sufficient care. Interview conducted with relevant party indicated that they have no concerns regarding the communication between staff and residents. Interview with staff member (S1) indicated that they are able to communicate with residents regarding their needs and is able to contact emergency services when needed.

** Report continued on 9099-C **
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 59-AS-20240918140226
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ALL SEASONS HIALEAH
FACILITY NUMBER: 342700929
VISIT DATE: 09/25/2024
NARRATIVE
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LPAs reviewed staff records for S1 and staff member (S2) and observed that both staff received training regarding care and supervision and communication with residents.

Based on interviews conducted, observations, and records reviewed, 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.

Exit interview was conducted with OD. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2