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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920091
Report Date: 05/15/2024
Date Signed: 05/15/2024 02:32:01 PM

Document Has Been Signed on 05/15/2024 02:32 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/
DIRECTOR:		MALIUCOV, SERGIUFACILITY TYPE:
740
ADDRESS:1652 WOODHAVEN CIRTELEPHONE:
(916) 305-1081
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6CENSUS: 1DATE:
05/15/2024
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Sergiu Maliucov, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a post licensing visit. LPA met with Sergiu Maliucov during today's inspection. Currently there are 1 residents in the facility.

LPA toured the facility with Administrator. LPA toured 6 resident rooms, 4 bathrooms, common living areas, caregiver room, kitchen, and outdoor area. In the areas toured no immediate health, safety, or personal rights violations were observed. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable.

LPA reviewed 1 resident file and 1 staff files. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates completed and training is complete.

No deficiencies cited during today's inspection.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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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