Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on a subsequent complaint investigation visit on 3/7/24 at 8:45am. LPA met with Licensee Valentina Marinova and stated the purpose of the visit.

During the visit LPA was unable to review Resident #1 (R1) facility records which were not made available for review during the visit.

In addition, LPA observed the Licensee did not submit Incident reports regarding falls and hospitalization's of R1. These deficiencies were confirmed by the Licensee during this visit.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this visit.

If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.

The Licensee was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights.

An exit interview was conducted and a copy of this report was provided.