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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700982
Report Date: 05/21/2021
Date Signed: 05/21/2021 12:14:37 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:SILVANA SENIOR CARE 3FACILITY NUMBER:
342700982
ADMINISTRATOR:IVASCU, KRISZTINAFACILITY TYPE:
740
ADDRESS:7662 COPPER COVE PL.TELEPHONE:
(916) 586-4713
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:6CENSUS: 2DATE:
05/21/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Krisztina Ivascu, AdministratorTIME COMPLETED:
11:00 AM
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An office meeting was held today, 5/21/2021, via teleconference line due to COVID-19 and precautionary measures. The purpose of today's meeting was to address an incident that occurred at the facility on 5/20/2021.

The following Licensing staff were present:
Alycia Berryman, Troy Ordonez, Laura Munoz, Anthony Perez, Michael Hood, and Danyle Wolter

The following representatives /present:
Administrator, Krisztina Ivascu

The following topics were covered during today's meeting:
  • Details and timeline of incident that occurred


Licensing Program Analysts (LPAs) Michael Hood and Danyle Wolter will follow-up with Administrator regarding the incident.

An exit interview was conducted and a copy of this report will be provided to the facility via email. A copy must be signed and returned to CCLD.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021
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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