Facility Evaluation Report

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a Required - 1 Year visit on 9/4/2025 Administrator certificate expires 01/15/2027 for Valentina Marinova. LPA Hayes met with Valentina Marinova and stated the purpose of today’s visit. The facility is licensed for a capacity of 6. The census was 5. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents.

LPA observed 2-day perishables and 7-day non-perishables. The most recent emergency drill was conducted on 08/25/25 at 1:00pm with 5 residents and 4 staff.

The temperature inside the facility was observed to be at 77*F, which is within the required range of 68-85*F. The hot water temperature was measured at 105.8 *F which is within the required range of 105-120*F.

LPA observed a fire extinguisher serviced 08/15/25 by Jorgensen Co., smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents. Medications and the medication administration record (MAR) was reviewed and was found to have inaccurate documentation and medication errors for medications provided to residents.

Staff were observed tending and cooking for residents in care. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and a guide.