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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700958
Report Date: 07/25/2022
Date Signed: 07/25/2022 05:23:17 PM

Document Has Been Signed on 07/25/2022 05:23 PM - 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:MITITI, BIANCAFACILITY TYPE:
740
ADDRESS:1245 CRESCENDO DRTELEPHONE:
(916) 586-4713
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 5DATE:
07/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Kristina Ivascu, LIcensee and Mirel IVascu, Administrator on call TIME COMPLETED:
05:25 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual.
LPA met with Eleshia Simpson and Julie-Ann Clark, caregivers, and explained purpose of inspection..Kristina Ivascu, LIcensee and Mirel Ivascu, Administrator on call arrived to the facility at approximately 4:15 pm. LPA observed (3) residents in the common area watching television and (2) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (2) residents. Currently, there is (1) resident on hospice. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. LPA was screened per Covid-19 precautionary measures upon entering the facility. and the following Personal Protective Equipment (PPE) was worn: surgical mask.

LPA and Licensee toured the interior and exterior of the facility including the common areas, resident bedrooms, resident bathrooms (2), kitchen and laundry area. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels and hand-washing posters posted. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, locked sharps in the kitchen and locked toxins in the garage. LPA observed the inside temperature to be 78*F. Fire extinguisher was last serviced 08/20/2021- re-servicing has been scheduled. Discussed vaccination status of residents/staff, eligibility for boosters and visitation protocols. All staff are cleared/associated. Administrator certificate #6052573740- exp 8/9/2023. Administrator to post an updated poster for Covid signs/symptoms.

LPA requested an updated copy of LIC500, LIC308 and the facility's Infection Control Plan be provided to the Department by 7/31/2022. LPA was provided with a copy of the current liability insurance during today's inspection.

There are no deficiencies issued during today's inspection.
Exit interview. Copy of report provided to Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2022
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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