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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005744
Report Date: 04/14/2022
Date Signed: 04/14/2022 04:20:32 PM

Document Has Been Signed on 04/14/2022 04:20 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:SILVER LINING CARE HOMEFACILITY NUMBER:
347005744
ADMINISTRATOR:EVELINA AND PAVEL MAGUREANFACILITY TYPE:
740
ADDRESS:8189 PLUMERIA AVENUETELEPHONE:
(916) 241-9186
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: 6CENSUS: 4DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH: Evelina Magurean, Administrator TIME COMPLETED:
04:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection. LPA met with Elena Romarniuc, caregiver, who contacted Administrator, Evelina Magurean, who, arrived shortly to the facility. LPA explained purpose of inspection. 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. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: KN95 mask. Facility currently has (4) residents and (3) residents are on hospice.

Administrator contacted the Department by phone at the start of the inspection to obtain/confirm the Personal Identification Number (PIN) to be able to make a payment for overdue annual fees on line.
LPA observed the Administrator pay the annual fees during today's inspection and receive a confirmation. Administrator confirmed she received the bill but it got misplaced.

Also discussed delays in Administrator recertification for Evelina. LPA sent an email to the Administrator Certification Unit during today's inspection since LPA was unable to contact the unit by phone.

LPA and Administrator discussed the vaccination status of residents and staff and exemptions and testing protocols in place.

LPA toured the facility to ensure the health and safety of the residents in care. LPA observed all residents to be in their rooms resting and no health and safety hazards to be observed.

There are no deficiencies cited in today's report.

Exit interview. Copy of report provided to Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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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