Silvana Senior Care 4

Allegation investigated: Facility staff did not adequately manage resident’s fall risk Staff failed to seek timely medical attention for resident

Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Wednesday April 22, 2026, to deliver findings for a complaint received on 1/26/2026. LPA met with Administrator Karcia and explained the purpose of the visit. Additionally, LPA spoke with Licensee Krisztina on the phone and explained the findings and citations. During the investigation, the Department conducted interviews and obtained documentation pertinent to the investigation. The result of the investigation is as follows: R1’s facility care plan indicated that they required 24-hour supervision and assistance with all activities of daily living. Per interviews, R1 would refuse to sleep in their bed and would sleep in their recliner instead. Multiple documents indicated that R1 was a fall risk including their appraisal dated 10/21/2025. R1’s plan of care stated they have a history of multiple falls with head injury. R1’s medical assessment dated 10/23/2025 stated R1 has a history of multiple falls. Additionally, hospital records dated 10/17/2025 and 1/2/2026 showed R1 was seen due to multiple falls. S1 and S2 were interviewed and indicated that R1 was a fall risk. The Licensee was interviewed and acknowledged that R1 was a fall risk. However, the investigation determined that there Substantiated were no fall preventative measures in place during the nighttime. S3 was live-in staff and could not provide any information about the care R1 required during the daytime or nighttime. S3 denied checking on residents during the nighttime. On 1/23/2026, at approximately 1500 hours, staff called 911 for R1 because they were complaining of left hip pain. R1 was admitted to Sutter Roseville Medical Center and diagnosed with a left hip fracture. The hospital contacted facility staff to determine how R1 may have sustained the fractured hip and there were no records of any recent falls. However, there was a text message from S3 to the facility group chat that indicated S3 found R1 on the floor on 1/23/2026 at 0400 hours. S3 placed R1 back in their bed. It was unknown how long R1 was on their bedroom floor prior to S3 finding them. Staff interviews indicated that protocol for unwitnessed falls is to call 911. Based on interviews conducted and documentation obtained, the preponderance of evidence standards have been met. Therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiency is being cited on the attached 9099-D page. As a result of the resident's serious bodily injury, an immediate civil penalty per Health and Safety Code § 1548 in the amount of $500 is being assessed for a violation that the Department determines resulted in the injury or illness of a person in care. An additional civil penalty assessment is under review and determination is pending. LPA will return on a future date to assess an additional civil penalty if warranted. See 9099-D for citations Exit interview conducted. A copy of the report and appeal rights provided. Based on LPA's interviews, the department has found the complaint allegation to be unsubstantiated,meaning that although the allegation may have happened or is valid, the preponderance of evidence standard has not been met, therefore the above allegation is found to be unsubstantiated. Exit interview conducted and a copy of the report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 22, 2026 · control 59-AS-20260126132637

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Apr 23, 2026

87468.2(a)(4) 87468.2 Additional Personal Rights of Residents . . . (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents . .(4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs.This requirement was not met as evidenced by: R1 being documented as a fall risk and not providing adequate supervision which poses an immediate health, safety, and personal rights risk to resident in care.the state’s words, verbatim · CDSS document, Apr 22, 2026

Plan of correction: Facility agrees to submit a plan regarding how the facility will manage resident's supervision during the day and nightime. Included in the plan will be the facility's staffing when resident's are identified as a fall risk.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(g) · Plan of correction due date: Apr 23, 2026

87465 Incidental Medical and Dental Care (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health . . . This requirement was not met as evidenced by R1 having an unwitnessed fall and staff not calling 911 for transport and evaluation which poses an immediate health, safety, and personal rights risk to resident in care.the state’s words, verbatim · CDSS document, Apr 22, 2026

Plan of correction: Facility agrees to submit training for all staff regarding emergency and 911 protocol.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Melissa Parks arrived unannounced on Wednesday April 22, 2026, to conduct a case management visit. LPA met with Administrator Karcia and explained the purpose of the visit. Additionally, LPA spoke with Licensee Krisztina on the phone and explained the case management visit and citation. During a complaint investigation (CONTROL NUMBER 59-AS-20260126132637), the Department determined that R1 had a fall on 1/2/2026 and was sent to Sutter Roseville Medical Center. R1 was diagnosed with a ground-level fall, scalp hematoma, and head trauma. An incident report was not completed or provided to the Regional office. Deficiency cited today on 809-D. Exit interview conducted and appeal rights and report provided.the state’s words, verbatim · CDSS document, Apr 22, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: May 6, 2026

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports. . . (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days . . .(D) Any incident which threatens the welfare, safety or health of any resident, . . .This requirement was not met as evidenced by R1 sustaining a fall and being sent to the hospital and the facility did not submit the required LIC624. This poses an indirect threat to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Apr 22, 2026

Plan of correction: Facility agrees to: submit a statement of understanding regarding the reporting requirement.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Thursday April 16, 2026, to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (6) and staff (2) files. All resident files contained the required paperwork. All staff files contained the required paperwork and training. LPA and Administrator Karcia toured the facility together to ensure the health and safety of residents in care. The following areas were inspected: resident bedrooms, bathrooms, kitchen, laundry room, garage and backyard. Facility was current on fire drills. All required postings were observed. All chemicals and knives were kept locked and inaccessible to residents. Fire extinguisher had a current inspection tag. LPA requested a copy of current liability insurance by 4/30/2026.. Exit interview conducted. No deficiencies cited. A copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Apr 16, 2026

Type of visit: Office

Licensing Program Analysts (LPAs) Bethany Mirlohi, Kevin Mknelly, and Melissa Parks, and Licensing Program Managers Troy Ordonez and Laura Munoz met licensee Krisztina Ivascu in person for an office visit. This meeting was initiated by licensee to discuss the following topics: Night supervision Staff supervision for dementia residents Live in staff Annual Fees Refund for hospice residents During today’s office meeting no deficiencies cited. Copy of report provided to licensee.the state’s words, verbatim · CDSS document, Apr 14, 2026

Type of visit: Office

On Tuesday February 10, 2026, at 9:00 AM, an informal conference was conducted virtually via Microsoft Teams Meeting. Present in the meeting was Licensing Program Manager (LPM) Maribeth Senty, Licensing Program Analyst (LPA) Melissa Parks, LPA Bethany Mirlohi, and Licensee representative Krisztina Ivascu. License was informed that this Informal conference is a part of the Administrative Action process and that further noncompliance may result in an elevation to a formal noncompliance conference, which could lead to a referral to the Department's legal division for possible revocation of license. The purpose of today’s meeting was to discuss solvency, plan of corrections, and facility administrators. Topic discussed: - Solvency - Past due annual fees - Plan of Corrections - Facility Administrators At this time, the Department agreed to monitor each facility. Additionally, the facility will provide the Department with the required documents and a schedule of each Administrator for each facility. Krisztina agreed to pay outstanding annual fees by 2/28/2026. The Department will submit a referral to the Technical Support Program. No deficiencies cited. Exit interview conducted. Informal meeting concluded and a copy of report will be emailed. Facility Representative Signature is expected to be signed and returned to LPA by close of business, 2/10/2026.the state’s words, verbatim · CDSS document, Feb 10, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Melissa Parks arrived unannounced to conduct a case management visit. LPA sent reminder emails about unpaid fees on 11/10/25 and 11/17/25. As of 12/2/25 administrator never sent LPA a copy of receipt and fees were not paid. Deficiencies were cited today on 809-D. Exit interview conducted and appeal rights and report provided.the state’s words, verbatim · CDSS document, Dec 2, 2025

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.185(a)(1) · Plan of correction due date: Jan 5, 2026

1569.185(a)(1)An application fee adjusted by facility and capacity shall be charged by the department for the issuance of a license to operate a residential care facility for the elderly. After initial licensure, a fee shall be charged by the department annually on each anniversary of the effective date of the license. This requirement is not met based upon outstanding Annual fee amount with late fee assessed. LIS payment history reviewed, which poses an potential health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Dec 2, 2025

Plan of correction: Facility agreed to pay balance of past due annual fees by 1/5/2026.

Allegation investigated: Staff allowed residents to leave the facility unsupervised

Licensed Program Analyst (LPA) Cassandra Mikkelson arrived at the facility unannounced and met with Karcia Walker to deliver findings for the above complaint allegation. During the investigation, LPA conducted interviews, conducted a tour of the facility, and reviewed documentation pertinent to the investigation. The results of the investigation are as follows: *** Report continued on 9099-C*** Unfounded Interviews with Administrators indicated that Resident R1 has exit seeking behaviors which the facility was aware of at time of move in. Interviews indicated that staff continue to monitor R1 at all times and if exit seeking behaviors occur, one staff member will follow R1 to ensure safety while the other staff members stayed at the facility with other residents in care. The facility has protocols in place to ensure resident safety and document all incidents of elopement. All parties were notified during and after each elopement behavior. Documents reviewed indicated that facility was aware of R1’s elopement behaviors and had put procedures in place to redirect and calm R1 when the behaviors occurred. Interviews and documents indicated that R1 never left the facility unsupervised. Records reviewed and interviews conducted indicated that during the incident that occurred on 06/12/2025, R1 opened the front door and walked out of the facility during a behavioral episode. Staff were monitoring R1 during that time and one staff member followed R1 to ensure safety while additional staff stayed at the facility to oversee other residents and call administrators. R1 walked around the neighborhood with staff member. Staff attempted to redirect R1 but were not able to so they continued to follow R1. Eventually returned to the facility once an Administrator had arrived at the facility and was able to redirect R1. Based on records reviewed and interviews, LPA finds the above allegation to be UNFOUNDED- meaning that the allegation was false, could not have happened and/or is without reasonable basis. Exit interview conducted with the Administrator. Copy of report was given to facility.the state’s words, verbatim · CDSS document, Jul 1, 2025 · control 59-AS-20250619083240

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced and met with Acting Administrator Karcia Walker to conduct an annual inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed five (5) resident rooms and three (3) common area bathrooms. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 118.0 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed six (6) resident files, two (2) staff files and resident medications. Facility has a current copy of certificate of liability insurance and LPA obtained a copy. As a result of this visit, no deficiencies were cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, Apr 9, 2025

Allegation investigated: Not enough staff to meet resident's needs Staff cannot communicate with resident

On 11/15/2024 Licensing Program Analysts (LPAs) Graham Gunby and Cheyenne Ratajczak, made an unannounced visit to the facility and met with Administrator Krisztina Ivascu. The purpose of this visit was to deliver the results of a complaint investigation. During the course of the investigation LPA interviewed the administrator and staff. LPA reviewed the following documents: Resident list, staff list with telephone numbers, admission agreements, care plans, care tracking, Physicians report. Continued on LIC9099-C Unsubstantiated Allegation: Not enough staff to meet resident's needs: Unsubstantiated R1 moved in on during the weekend. R1 does not have a responsible party or any local family. R1 was extremely combative towards care staff. Per R1s LIC602 they are non-ambulatory but can state their own needs and is a one person assist. After reviewing R1’s LIC602 and interviews with the staff, it is determined that R1 can bare weight during transfer and is not a 2 person assist. During interviews it was revealed that there is one care staff on the weekends and two care staff during the week. In interviews with staff LPAs learned that if needed on the weekends other care staff are available to assist. Allegation: Staff cannot communicate with resident: Unsubstantiated During the relocation into the facility R1 had not received their updated medications and was having behavioral breakdowns. During this time, R1 was speaking in Romanian and the caregivers were unable to communicate with the resident. While opening the complaint the resident was on updated medication and was able to communicate clearly and in English to LPAs and staff. During interviews with staff it was revealed that staff and R1 are able to clearly communicate with one another. Based on LPA's observations and interviews, the department has found the complaint allegations to be unsubstantiated, meaning that the although the allegations may have happened or are valid, the preponderance of evidence standard has not been met, therefore the above allegations are found to be unsubstantiated. Exit interview conducted and a copy of the report and appeal rights were emailed to the Administrator. LPAs printer was not working.the state’s words, verbatim · CDSS document, Nov 15, 2024 · control 59-AS-20240925143949

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Wednesday April 3, 2024 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Parks reviewed resident (6) and staff files (2). All resident files contained the required paperwork. All staff files contained the required paperwork and training. LPA Parks and Administrator Krisztina toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, living room, kitchen, and garage. In the areas toured, there were no health or safety violations observed. Facility was clean and well organized. Facility has PPE supply on hand. All required posting were observed. No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the facility.the state’s words, verbatim · CDSS document, Apr 3, 2024

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 caregivers to deliver investigation findings. Administrator arrived to assist 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. R2, who has continually worked at the home was interviewed. 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-20230814143452