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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700244
Report Date: 04/29/2026
Date Signed: 04/29/2026 12:09:27 PM

Document Has Been Signed on 04/29/2026 12:09 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SPRING VIEW GARDENS CARE HOMEFACILITY NUMBER:
342700244
ADMINISTRATOR/
DIRECTOR:		TAFTA, DANIELFACILITY TYPE:
740
ADDRESS:9964 SPRING VIEW WAYTELEPHONE:
(916) 273-2175
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 6CENSUS: 4DATE:
04/29/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Mihaela Tafta and Daniel TaftaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On April 29, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct the annual inspection visit. LPA met with the administrator, Daniel Tafta (AD), and staff on duty, Mahaela Tafta (S1), and stated the purpose of the visit. Present during this visit were 3 residents in care with 2 staff on duty (AD and S1).

Overview: Facility is a two-story home located in a residential neighborhood. Residents lives the downstairs only. Facility is licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory and can accept/retain 1 bedridden. Room #2 of the facility sketch was fire cleared for 1 bedridden use. Facility does manage residents’ cash resources. Facility does not have clearance for delayed egress, and/or locked interior/exterior.

Physical Inspection: Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas.

LPA and S1 inspected 4 resident bedrooms and 1 bathroom. Hot water temperature was at 117 degrees Fahrenheit. Fire door was observed going to rooms #1 & #2 and it will automatically close when the fire alarm is activated. Room #2 is also equipped with a fire door. Exit door in room #2 drags at the bottom when opening. Administrator was advised to make necessary repair. During this visit, the AD fixed it. In bedroom #4, LPA observed a Hoyer lift that is used as needed. Advisory was provided to ensure all staff have training on how to use this device. LPA observed indoor cameras. Per record reviews, signed documents regarding cameras by residents/responsible party was observed. LPA observed smoke detectors and 2 carbon monoxide detectors.

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NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Arvin Villanueva
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SPRING VIEW GARDENS CARE HOME
FACILITY NUMBER: 342700244
VISIT DATE: 04/29/2026
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In the kitchen, LPA observed at least 7-day nonperishable and 2-day perishable food items. Fresh fruits and vegetables were observed. Pantry was observed. Fire extinguisher was observed in the kitchen area and last purchased on March 3, 2026 (with receipt). Knives and sharps were locked in drawer.

The garage is not accessible to residents in care, and it is kept locked and can be accessed with a key. The laundry room can be unlocked without a key. Advisory was provided to change the knob that needs a key to unlock, if they choose to keep laundry detergents and other cleaning solutions inside the laundry room. Exits, hallways, and walkways were observed to be clear and unobstructed.

Outdoor area was inspected. Walkway to the exit gate was clear and unobstructed. Sheds were observed to be locked. Fence and gates were in good condition at this time. No bodies of water were observed at this time. There is a shaded area with outdoor furniture in the backyard. Cameras were observed throughout. Shut off valves were located. Advisory was provided to ensure all staff know the location of each valve and know how to operate each one in case of emergency.

Record Reviews: Review of 2 of 4 resident files was conducted, including but not limited to, review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. PRN Authorization Letter was on file for bot resident.

Medication reviews were conducted for 1 resident. Advisory was provided to ensure all nutritional supplements and similar items are stored in a locked storage since there is at least one resident may be at risk if they have access to such items. .

Review of 4 staff files included but not limited to background clearance, first aid/CPR certification, and training.

Documents Requested: LPA requested a copy of updated Liability Insurance Certificate, LIC610, LIC500, and LIC308.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were cited and advisories were provided.

Exit interview was conducted. A copy of the report was provided upon exit.

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NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Arvin Villanueva
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC809 (FAS) - (06/04)
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