SILVANA SENIOR CARE 5

Official classification

Type B

Official code

1569.185(a)(1)

Regulation authority

HSC

What the official deficiency says

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.

Official plan of correction

Administrator paid annual fees today while LPA was on the phone and emailed a copy of receipt. Deficiency was cleared during today's inspection.

Deadline recorded: Oct 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87467(a)(3)

Regulation authority

CCR

What the official deficiency says

(a) Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will receive in the facility, and the resident's preferences regarding the services provided at the facility. (3) The licensee shall arrange a meeting with the resident and appropriate individuals identified in Section 87467(a)(1) to review and revise the written record as specified, when there is a significant change in the resident's condition, or once every 12 months, whichever occurs first. Significant changes shall include, but not be limited to occurrences specified in Section 87463, Reappraisals. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 1 out of 3 persons which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/19/2024 Plan of Correction Administrator agrees to complete an updated needs and service plan for R1. Updated needs and service plan to be sent into CCL by 4/19/24.

Official classification

Type A

Official code

87705(c)

Regulation authority

CCR

What the official deficiency says

87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. Based on interviews conducted, the Licensee did not ensure that resident (R1) was unable to leave the facility unassisted which posed an immediate health and safety risk to residents in care.

Official plan of correction

Administrator has made a doctor appointment for R1. In addition administrator to submit to CCL their plan on supporting R1's care needs with an updated needs and service plan.

Deadline recorded: Apr 20, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87307(a)

Regulation authority

CCR

What the official deficiency says

87307 Personal Accommodations and Services. (a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. Based on interviews and facility tour, staff are sleeping in the common living area which poses a potential health and safety risk to residents in care.

Official plan of correction

Administrator states they applied for city building permits. Administrator to submit to CCL a new facility sketch of where the staff room will be. Facility sketch to be sent into CCL by 4/28/23.

Deadline recorded: Apr 28, 2023. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87755(c)

Regulation authority

CCR

What the official deficiency says

87755-Inspection Authority of the Licensing Agency.(c)-The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours. This requirement was not met as evidenced by: Licensee did not provide requested documents to department as requested on 08/02/22 for R1s admission agreement. This poses a potential health, safety, and/or personal rights risk to residents in care.

Official plan of correction

Licensee to review section 87755 for Inspection Authority of the Licensing Agency and send a letter of understanding to Community Care Licensing by 11/03/22 by fax. Additionally, licensee to ensure that facility will provide any requested documents to department in future.

Deadline recorded: Nov 3, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87507(g)(5)(A)(1)

Regulation authority

CCR

What the official deficiency says

87507(g)(5)(A)(1)- Admission Agreements(g) Admission agreements shall specify the following: (5) Refund conditions(A) Facility policy concerning refunds, ...conditions under which a refund for ... fees will be returned in the event of a resident’s death, pursuant to Health and Safety Code section 1569.652… must be made to the individual...for the payment of the resident’s fees,... identified in admission agreement. 1569.652(c) A refund … within 15 days after the personal property is removed. This requirement was not as evidence by- facility did not pay the refund to R1s family/responsible party within 15 days of R1s death as required per regulation.

Official plan of correction

Licensee will submit a statement of understanding of this regulation and proof of payment of refund to CCL by the POC date- 11/03/22.

Deadline recorded: Nov 3, 2022. A deadline is not proof that correction was completed.