<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700958
Report Date: 05/25/2021
Date Signed: 05/25/2021 11:49:26 AM

Document Has Been Signed on 05/25/2021 11:49 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:SILVANA SENIOR CARE 2FACILITY NUMBER:
312700958
ADMINISTRATOR:IVASCU, MIRELFACILITY TYPE:
740
ADDRESS:1245 CRESCENDO DRTELEPHONE:
(916) 586-4713
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 0DATE:
05/25/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Krisztina IvascuTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) K. Hiratsuka, arrived at the facility announced on 05/252021 to conduct an announced prelicensing visit. LPA met with Krisztina Ivascu, and explained the purpose of the visit. Prior to initiating the prelicensing visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted applicant and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by Loredana Pop, the applicant's sister.

This facility has a fire clearance for six non-ambulatory residents. There is a gate in the front yard creating an enclosed space and the gate is not going to be locked. This facility has four resident rooms; two private and two shared. There is no staff room so this facility is required to have awake staff at all times. The main entrance opens into a small foyer. To the left of the main entrance is the dining, kitchen, main common area, and one shared resident room. The shared resident room cannot be used as a pass-through for residents to go to the backyard. There is a door on the right side of the main entrance that leads to two private resident rooms, one shared resident room that has its own sitting room, full private bathroom and an exit to the front yard, one full common bathroom, and the clothes washer and dryer in a closet.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 2
FACILITY NUMBER: 312700958
VISIT DATE: 05/25/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The backyard was inspected. There is a locked shed in the backyard. The gate to the front yard is on the same side as the garage. The garage is going to be used for storage. The kitchen was inspected. There are locked drawers for sharps. There is a locked cabinet in the main common area that is going to be used to store medications, files, and other confidential information.

This facility meets licensing requirements. Several topics were discussed. Component III orientation was waived by LPA because Applicant owns several other facilities.

LPA is going to submit this report to the application specialist for final review.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2