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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920091
Report Date: 01/25/2024
Date Signed: 01/25/2024 02:34:39 PM

Document Has Been Signed on 01/25/2024 02:34 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
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME:DIAMOND WOOD SENIOR CARE LLCFACILITY NUMBER:
315920091
ADMINISTRATOR:MALIUCOV, SERGIUFACILITY TYPE:
740
ADDRESS:1652 WOODHAVEN CIRTELEPHONE:
(916) 305-1081
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6CENSUS: 0DATE:
01/25/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Sergiu Maliucov, AdministratorTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived to conduct a pre-licensing inspection. LPA met with licensee Vitalie and Sergiu Maliucov and during today's inspection. LPA ensured they applied hand sanitizer before entering the facility.

Facility was inspected both indoors and outdoors. LPA inspected 6 resident bedrooms, 5 bathrooms, 1 staff room, common living areas, kitchen, garage, and outdoor areas. Outdoor area is free from hazardous debris. Outdoor exits are clear and accessible. First aid kit was present in the facility. Centrally stored medications will be locked in pantry near the kitchen area. LPA inspected resident bedrooms and the bedroom had appropriate furnishings, adequate lighting and storage. Bathrooms are clean, sanitary, and in good repair. Grab bars and non-skid mat was present in all bathrooms. Smoke detectors and carbon monoxide detectors were checked. Fire clearance was granted on 12/22/23 for 6 non-ambulatory residents of which 1 may be bedridden in bedroom #1. Kitchen is clean, sanitary, and in good repair. A working telephone has be set up for residents use.

Licensee agrees to notify LPA once first consumer is admitted. This report will be forwarded to the centralized application unit for continued processing. Comp III was completed today during the inspection.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2024
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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