Silvana Senior Care

Allegation investigated: Licensee did not provide comfortable living accommodations and privacy for the staff who resided in the facility

On 9/29/23, Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with Administrator to deliver investigation findings. LPA reviewed staff records and facility records. LPAs also conducted inspections and conducted interviews. LPA finds that facility met Tittle 22 requirements. The staff alleged to have not been provided reasonable living accommodations, no longer work at the facility. Phone contact to one staff was not responded to. An email for another staff mentioned was no longer active. The Department has conducted various inspections during the time the staff accommodations violations are alleged to have occurred. Inspections, records and interviews found that when staff have stayed at the facility for non-work times, they have been provided reasonable break and living accommodations. This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. Exit interview conducted and report provided. Unfoundedthe state’s words, verbatim · CDSS document, Sep 29, 2023 · control 59-AS-20230814142430

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 9/26/23 to conduct a Annual Inspection utilizing the CARE inspection tool. LPA met with Administrator and explained the purpose of the visit. There are currently Covid positive residents at the facility. LPA wore N-95 mask. File reviews conducted outside. LPA toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. PPE supplies present. Staff observed to properly use PPE. LPA reviewed resident files. Files were complete. LPA and designee discussed resident who receives services from another agency, their continued placement and retaining documents required by the other agency. LPA reviewed staff files. Files complete for forms and training. Advisory for restricted conditions training to be on file. No deficiencies are being cited as a result of todays inspection. Exit interview conducted. Report provided.the state’s words, verbatim · CDSS document, Sep 26, 2023

Allegation investigated: Staff did not ensure that resident's hygiene needs were met.

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 05/31/23 to do the complaint investigation for above allegation. LPA met with administrator Krisztina Ivascu and explained the purpose of the visit. LPA wore the following Personal Protective Equipment (PPE) during today's visit-surgical mask. LPA was screened by facility staff upon entry. The department conducted facility observations and interviews (2 staff and 2 residents) to investigate the complaint. **Report continued on LIC9099-C** Unsubstantiated ***continued from LIC9099.......... Allegation- Staff did not ensure that resident's hygiene needs were met. The department conducted interviews and facility observation to investigate above allegation. During interviews with facility staff and residents, facility is providing appropriate care to the residents according to resident’s needs and service plans. During residents’ (2) interviews on 05/31/23 , residents stated that facility has enough staff and their care needs are met. During 2 staff interviews on 05/31/23 , staff stated that there are enough staff to work at the facility to meet resident’s care needs. Staff and residents interviewed on 05/31/23 indicated that staff were providing incontinence care to residents every 2 hours or as needed per their needs and service plan. Residents interviewed indicated that staff were not leaving them soiled for long times and staff provide assistance for their incontinence care needs as needed. During record review for R1, records indicated that facility did provide all required staffing and assistance to meet R1s care needs. During department visit on 05/31/23, department observed that residents appeared to be well groomed and in good care, therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiency was cited during this visit. Exit interview conducted and copy of this report left with Administrator.the state’s words, verbatim · CDSS document, May 31, 2023 · control 59-AS-20230525110038

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 9/12/22 to conduct a Required- 1 Year Inspection utilizing the infection control domain. LPA met with staff and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 protocols, and self-screening questionnaire for symptoms of COVID-19 infection . LPA completed a facility risk assessment upon arrival. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA self screened upon entering the facility. LPA requested for staff to notify Administrator that LPA is present at the facility to conduct an annual inspection. LPA toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured LPA advised improvements. LPA and caregivers completed the infection control domain and facility was found to be in substantial compliance at this time. LPA advised facility to increase documentation of daily screening for staff, residents and visitors, Staff receive N-95 fit testing and develop staff break area and submit infection control plan. LPA requested for documents: Resident roster, LIC 500 Including , Liability Insurance. No deficiencies are being cited at this time. Exit interview conducted and copy of report left at the facility.the state’s words, verbatim · CDSS document, Sep 12, 2022

Allegation investigated: Staff gave paramedics file for resident with another resident's medication sheet.

On 5/27/2022, Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Andrei Dumitiriu, to conclude a complaint investigation into the allegation listed above. LPA wore an N-95 mask. During the investigation, the department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: Allegation: Staff gave paramedics file for resident with another resident's medication sheet. ** Report continued on 9099-C ** Substantiated Interview with staff member (S1), conducted on 11/10/2021, indicated that paramedics arrived at the facility to assist with transferring resident (R1) to the hospital on 11/4/2021. S1 stated that they gave paramedics R1's file. However, as S1 was making copies of documents from R1's file, they noticed that the files copied were not for R1. S1 stated that they attempted to correct the matter by finding the correct files for R1 and making copies for paramedics. However, paramedics refused to wait for S1 and left with the copies initially made before S1 acknowledged the error. During inspection conducted on 11/10/2021, LPAs Michael Hood and Angela Hood conducted a review of R1's file. LPAs observed that R1 had a Medication List with a name that was not R1's. Interview with Administrator, Andrei Dumitriu, indicated that no residents at the facility shared the name of what was indicated on the Medication List in R1's file. Administrator stated that the hospice agency providing services to R1 was responsible for placing the wrong Medication List in R1's file. During inspection conducted on 5/27/2022, LPA Michael Hood conducted a review of R1, R2, R3, R4, R5, and R6's file. LPA did not observe any other documents mixed with another resident's file, but did observe at least one required document missing from each resident's file. Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22 Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. The Administrator’s signature on these forms acknowledges receipt of these documents. Interview with staff member (S1), conducted on 11/10/2021, indicated that paramedics arrived at the facility to assist with transferring resident (R1) to the hospital on 11/4/2021. S1 stated that they gave paramedics R1's file. However, as S1 was making copies of documents from R1's file, they noticed that the files copied were not for R1. During inspection conducted on 11/10/2021, LPAs Michael Hood and Angela Hood conducted a review of R1's file. LPAs observed that R1 had a Medication List with a name that was not R1's. Based on interview with S1 and LPAs observations of R1's file, it is determined that paramedics received the correct facility file for R1, despite not all documents belonging to R1. Allegation: Staff may not be administering the right medications to the resident. During inspection conducted on 5/27/2022, LPA Michael Hood conducted a medication count for R2, R3, and R4, comparing each resident’s Centrally Stored Medication Form (CSM) with medications centrally stored for the resident. LPA did not observe any errors when comparing medication count with CSMs for R2, R3, and R4. Based on interviews conducted by the Department and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, May 27, 2022 · control 25-AS-20211104140114

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Jun 10, 2022

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Based on interviews conducted and records reviewed, facility did not ensure that resident files were complete and did not ensure R1's documents were seperate from another individual, which poses a potential health, safety, and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 27, 2022

Plan of correction: Administrator agrees to complete the files missing from the file review conducted for residents on 5/27/2022. Administrator will also complete a statement of understanding regarding regulation 87506 and resident records. Administrator will submit requested documents and statement of understanding to department by POC due date.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Michael Hood met with Administrator, Andrei Dumitriu, to conduct an inspection. During inspection, LPA observed a staff member not wearing a mask while on the premises. LPA provided technical assistance regarding staff not wearing masks while on the premises. Exit interview was conducted with Administrator. A copy of this report was provided. The Administrator’s signature on this form acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, May 27, 2022

Type of visit: Office

An Office Meeting was conducted at 11:00 AM on 3/25/2022 at the Sacramento North Regional Office virtually via Microsoft Teams. Present for the meeting was: Administrator Krisztina Ivascu Staff Andrei Dumitriu LPM Laura Munoz LPM Troy Ordonez LPM Maribeth Senty LPM Anthony Perez LPA Kevin Mknelly LPA Talwinder Bains LPA Jacob Williams The purpose of the Office Meeting was to discuss the situation surrounding Silvana Senior Care, Inc. The Department has concerns stemming from site inspections on multiple dates during the year 2021 and 2022. Issues discussed during the meeting were: regulations regarding selling a business, Andrei Dumitriu advertising that he is owner/administrator on business cards when he is not owner/administrator, false information listed online & removing advertising with the name "Anca", state license is non-transferrable, whenever there is more than a 50% change of ownership a new license is required, number of facilities Krisztina Ivascu is acting Administrator, Nanny's Nest change of ownership from Staci Barnes to Krisztina Ivascu, the required time administrator must spend at each facility (roughly ~20 hours). CCL is requesting LIC500 & LIC308 for each Silvana Senior Care, Inc. facility. Copy of report provided via email.the state’s words, verbatim · CDSS document, Mar 25, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Williams arrived at the facility unannounced on 09/23/2021 to conduct a Required 1- Year Inspection utilizing the infection control domain. LPA met with Administrators Krisztina Silvana Ivascu, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and contacted licensee and completed a facility risk assessment. LPA ensured he applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened by facility staff upon entering the facility. LPA and staff toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, four (4) resident bedrooms, two (2) bathrooms, kitchen, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and administrator completed the infection control domain and facility was found to be in substantial compliance at this time. No deficiencies are being cited as a result of today’s inspection. Exit interview conducted and copy of report left at the facility (LPA encountered FAS Consistency Check following Infectious Control questionnaire, while waiting for FAS to upload again the Administrator had to leave & gave permission for caregiver to sign report).the state’s words, verbatim · CDSS document, Sep 23, 2021

Allegation investigated: Facility is in disrepair

Prior to entering the facility, LPA Smith spoke with staff to pre-screen that the facility is COVID free. Analyst also self-screened for having no known symptoms or exposure. Analyst followed facility's screening protocols, wore an N-95 respirator and maintained distance during the visit. LPA Smith conducted an unannounced complaint visit and met with Tomar Reid. LPA conducted the initial 10 day visit and observed a brand new outside air conditioning unit. Licensee stated that the A/C did break and the facility immediately contacted the A/C company to get the non operational A/C working again. Today's visit revealed the A/C was properly working as all of the necessary parts have been replaced. As a result of this investigation, LPA finds the allegation that facility is in disrepair to be SUBSTANTIATED. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. However, no citation will be issued as mechanical items will eventually wear out, break and need repair. Facility took the immediate and necessary steps to fix the unit. Substantiatedthe state’s words, verbatim · CDSS document, Aug 26, 2021 · control 25-AS-20210715145031

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Allegation investigated: -Resident was injured by another resident while in care.

Licensing Program Analyst (LPA) Praveen Singh conducted this unannounced visit with Direct Care Staff Tomar Reid to deliver findings on the above allegation. Prior to this visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Facility Representative and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. This complaint allegation was accepted by the Department's Investigations Branch (IB) as a full investigation. The Department reviewed records and conducted interviews. Based on the information gathered there was not sufficient evidence to substantiate neglect and/or lack of supervision resulting in R1 sustaining injuries. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted with Administrator Krisztina Silvana Ivascu over the phone and a copy of this report provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 16, 2021 · control 25-AS-20210414152518