Inspection Reports for Coterie Cathedral Hill
1001 Van Ness Ave, San Francisco, CA 94109, United States, CA, 94109
Back to Facility ProfileInspection Report Summary
Most inspections found no deficiencies, with routine annual and complaint investigations generally showing compliance and proper operation. The most recent report from September 30, 2025, had no deficiencies and confirmed the facility responded appropriately to an external scam targeting a resident. Some substantiated complaints in the past involved medication safety, timely response to call bells, failure to report staff COVID-19 cases, and a serious incident where staff manually disabled an alarm allowing a resident to leave unattended, posing an immediate health risk. Several other complaint investigations were unsubstantiated, including concerns about staffing, infection control, and facility equipment. The facility’s record shows improvement over time, with the latest inspections free of deficiencies after addressing earlier issues.
Deficiencies per Year
4
3
2
1
0
High
Moderate
Census Over Time
Census
Capacity
Inspection Report
Census: 207
Capacity: 260
Deficiencies: 0
Sep 30, 2025
Visit Reason
The visit was a case management visit concerning a report of suspected abuse received on 2025-09-22 involving a resident who was targeted by an unknown caller requesting a money transfer.
Findings
The facility confirmed no calls were made to the resident by staff, and the resident was a victim of an external scam. The facility submitted an incident report to Community Care Licensing and sent a scam prevention notice to all residents. No deficiencies were cited during this visit.
Complaint Details
The visit was triggered by a complaint of suspected abuse involving an unknown caller impersonating facility staff and obtaining money from a resident. The complaint was investigated and substantiated as a scam from an outside source, not involving facility staff.
Report Facts
Capacity: 260
Census: 207
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matthew Turner | Administrator | Met with Licensing Program Analyst during the visit and provided information about the incident |
| Yi Sam Jian | Licensing Program Analyst | Conducted the case management visit |
| Brenda Chan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Capacity: 260
Deficiencies: 1
May 21, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2025-03-06 alleging that staff did not ensure medications were inaccessible to residents in care and did not properly administer or manage medications.
Findings
The complaint that staff did not ensure medications were inaccessible to residents was substantiated based on evidence that resident R1's medications were left accessible in their bedroom, posing an immediate health and safety risk. However, allegations that staff did not administer medication as prescribed or properly manage medication records were found to be unsubstantiated due to insufficient evidence.
Complaint Details
The complaint was substantiated regarding medication accessibility, with photo evidence showing prescription medications left accessible in resident R1's bedroom. The complaint regarding improper administration and management of medication was unsubstantiated due to lack of corroborating evidence.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Licensee/Administrator failed to ensure R1's medications were kept safe and not accessible to residents in care. | Type A |
Report Facts
Facility capacity: 260
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Matt Turner | Executive Director | Met with Licensing Program Analyst during the investigation |
| Deborah Suarez | Administrator | Facility administrator named in the report |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Annual Inspection
Census: 193
Capacity: 260
Deficiencies: 0
Feb 27, 2025
Visit Reason
An unannounced Annual Required – 1 year inspection was conducted to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be clean, well-maintained, and operating safely with no deficiencies cited. Resident care, staff training, medication management, and safety systems were all in order.
Report Facts
Residents receiving hospice services: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Deborah Suarez | Administrator | Named as facility administrator with valid certificate |
| Matt Turner | General Manager | Met during inspection and named as General Manager with valid certificate |
| Dominic Tobola | Licensing Program Analyst | Conducted the inspection |
| Andrea Medlin | Licensing Program Manager | Named as Licensing Program Manager |
Inspection Report
Complaint Investigation
Capacity: 260
Deficiencies: 0
Nov 21, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that facility staff were not meeting resident needs, specifically regarding Activities of Daily Living (ADL) including room checks, continence care, and medication administration assistance for resident R1.
Findings
The investigation found that the allegations were unsubstantiated. Evidence showed that ADL tasks were documented as completed, often by an outside private caregiver who dismissed facility staff. Medication administration times were within the facility's allowed one-hour window, and medication records indicated compliance with prescribed instructions.
Complaint Details
The complaint alleged that facility staff were not meeting resident R1's needs for ADL and medication administration. The investigation found no preponderance of evidence to prove violations, and the complaint was unsubstantiated.
Report Facts
Capacity: 260
Documentation entries: 200
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Matt Turner | General Manager | Met with Licensing Program Analyst during the investigation and provided statements |
| Sirun Sarah Laloyan | Administrator | Facility administrator named in the report |
| Andrea Medlin | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 180
Capacity: 260
Deficiencies: 0
Nov 14, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 08/30/2024 alleging that facility devices, including elevators and a swimming pool lift, were not properly working.
Findings
The investigation found that one of four elevators was not operating on the date of the alleged incident, but three elevators were functioning and accessible. The swimming pool lift was in the process of repair and awaiting parts. Documentation of repair services was provided, and at the time of final inspection, all devices were operating. Due to lack of corroborating evidence, the complaint was found to be unsubstantiated.
Complaint Details
Complaint alleges facility devices not properly working including elevator and swimming pool lift. The allegation was found to be unsubstantiated due to contradicting information and lack of corroborating evidence.
Report Facts
Facility capacity: 260
Census: 180
Complaint received date: Aug 30, 2024
Elevators: 4
Elevators not operating: 1
Elevators operating: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dominic Tobola | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Matt Turner | General Manager | Facility representative interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 165
Capacity: 260
Deficiencies: 0
Sep 5, 2024
Visit Reason
An unannounced complaint investigation visit was conducted to address allegations that staff did not do a proper assessment, were charging residents for services not rendered, and were not following the admission agreement.
Findings
The investigation found that both residents had signed admission agreements and did not move in due to increased care needs and rates. The facility upheld the 60-day notice rule and charged accordingly. The allegations were determined to be unfounded and the complaint was dismissed.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegations were false, could not have happened, or were without reasonable basis.
Report Facts
Capacity: 260
Census: 165
Notice period: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the complaint investigation visit |
| Matt Turner | General Manager | Met with Licensing Program Analyst during the investigation |
Inspection Report
Complaint Investigation
Census: 144
Capacity: 260
Deficiencies: 1
May 24, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted due to a complaint received on December 14, 2023, alleging that resident call bells were not answered timely due to lack of staffing.
Findings
The investigation found multiple occasions where resident call buttons were not responded to in a timely manner, substantiating the complaint of a violation of residents' personal rights related to timely response to call bells.
Complaint Details
The complaint allegation regarding untimely response to resident call bells due to lack of staffing was substantiated based on the preponderance of evidence.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to respond to resident call buttons in a timely manner in 3 out of 3 cases, posing a potential health and/or safety risk. | Type B |
Report Facts
Capacity: 260
Census: 144
Deficiency cases: 3
Plan of Correction Due Date: Jun 10, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Calandra | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Andrea Medlin | Licensing Program Manager | Oversaw the complaint investigation report |
| Matt Turner | General Manager | Facility representative met during investigation |
| Deborah Suarez | Assistant General Manager | Arrived during the investigation visit |
Inspection Report
Annual Inspection
Census: 144
Capacity: 260
Deficiencies: 0
Feb 16, 2024
Visit Reason
The inspection was an unannounced required 1-year annual inspection conducted to evaluate compliance with licensing requirements.
Findings
The facility was found to be in compliance with all regulations, including proper water temperature, safety equipment, food storage, medication management, and staff documentation. No deficiencies were cited during the visit.
Report Facts
Number of resident files reviewed: 5
Number of staff files reviewed: 5
Number of staff interviewed: 3
Number of residents interviewed: 3
Fire extinguisher last inspection date: Jan 30, 2024
Water temperature range: 105
Water temperature range: 120
Facility temperature: 70
Non-perishable food supply: 7
Perishable food supply: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Deborah Suarez | Assistant General Manager | Met during inspection and involved in report review |
| Matthew Turner | General Manager | Met during inspection and involved in report review |
| Shirley Cheung | Care Coordination Director | Met during inspection and involved in report review |
| John Calandra | Licensing Program Analyst | Conducted the inspection |
Inspection Report
Complaint Investigation
Census: 125
Capacity: 260
Deficiencies: 0
Oct 31, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to a complaint received on 07/25/2023 alleging that the licensee does not ensure the facility has sufficient staff to meet the care needs of residents.
Findings
The investigation included interviews, document reviews, and observations of the memory care unit. No staff shortages were identified, and the facility scheduling demonstrated adequate staffing to meet residents' needs. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint alleged insufficient staffing to meet resident care needs. The allegation was unsubstantiated after investigation.
Report Facts
Facility capacity: 260
Census: 125
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Calandra | Evaluator / Licensing Program Analyst | Conducted the complaint investigation visit |
| Shirley Cheung | Care Coordination Director | Met with investigators during the visit |
| Deborah Suarez | Assistant General Manager | Met with investigators during the visit |
| April Cowan | Licensing Program Manager | Participated in the complaint investigation visit |
| Jaime Vado | Licensing Program Analyst | Conducted investigation activities on October 10, 2023 |
| Cara Smith | Licensing Program Manager | Named in report signature section |
Inspection Report
Follow-Up
Census: 124
Capacity: 260
Deficiencies: 0
Oct 25, 2023
Visit Reason
The visit was a follow-up regarding an incident report received on September 21, 2023, about a resident who left the facility unattended.
Findings
The resident had left the facility with other residents for a community walk with their spouse and returned to notify staff they wished to continue walking without signing in or out. This was not considered abnormal practice. No deficiencies were cited during this visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| John Calandra | Licensing Program Analyst | Conducted the follow-up visit related to the incident report. |
| Cara Smith | Licensing Program Manager | Conducted the follow-up visit related to the incident report. |
| Sarah Laloyan | Senior Vice President of Operations | Provided information regarding the resident's incident. |
| Shirley Cheung | Care Coordination Director | Provided information regarding the resident's incident. |
| Deborah Suarez | Assistant General Manager | Provided information regarding the resident's incident and stated the practice was not abnormal. |
Inspection Report
Census: 114
Capacity: 260
Deficiencies: 0
Aug 28, 2023
Visit Reason
The visit was a case management visit conducted concerning a report of suspected abuse received on 2023-08-07 involving a private duty aide.
Findings
No deficiencies were cited during the visit. The private duty aide involved in the abuse allegation was removed from the facility, and the facility has suggested residents hire from preferred agencies.
Complaint Details
The visit was triggered by a report of suspected abuse where a resident alleged sexual abuse by a private duty aide. The aide was fingerprinted through the agency and removed from the facility upon the report. Documentation regarding the aide is to be submitted to the Licensing Program Analyst.
Report Facts
Capacity: 260
Census: 114
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Donato | Licensing Program Analyst | Conducted the case management visit and explained the purpose of the visit |
| Jackie Jin | Licensing Program Manager | Named in the report header |
| Shirley Cheung | Care Coordinator Director | Met with the Licensing Program Analyst during the visit |
| Deborah Suarez | Assistant General Manager | Met with the Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 114
Capacity: 260
Deficiencies: 0
Aug 23, 2023
Visit Reason
An unannounced complaint investigation visit was conducted to investigate an allegation that staff did not comply with infection control practices resulting in a health and safety risk.
Findings
The investigation found that infection control plans were in place and being followed, COVID-19 positive residents were isolated, staff were observed using appropriate protective equipment, and notifications to family members were ongoing. The allegation was determined to be unfounded and no citations were issued.
Complaint Details
The complaint alleged that staff did not comply with infection control practices resulting in a health and safety risk. The complaint was found to be unfounded, meaning the allegation was false, could not have happened, or was without reasonable basis.
Report Facts
Capacity: 260
Census: 114
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the complaint investigation visit |
| Shirley Cheung | Resident Care Director | Met with Licensing Program Analyst during investigation |
| Deborah Suarez | Assistant General Manager | Met with Licensing Program Analyst during investigation and reviewed report |
| Cara Smith | Licensing Program Manager | Named in report header and signature section |
| Sirun Sarah Laloyan | Administrator | Facility administrator named in report |
Inspection Report
Complaint Investigation
Census: 110
Capacity: 260
Deficiencies: 0
Jul 26, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not address a scabies outbreak among residents and did not meet residents' hygiene needs.
Findings
The investigation found that the facility did respond appropriately to the scabies outbreak by notifying authorities, treating affected residents and staff, and providing hygiene care. The allegations were determined to be unsubstantiated due to lack of evidence.
Complaint Details
The complaint alleged that staff did not address a scabies outbreak and failed to meet residents' hygiene needs. The investigation found no preponderance of evidence to substantiate these allegations.
Report Facts
Capacity: 260
Census: 110
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarah Lolayan | Executive Director | Interviewed during the investigation and named in findings |
| Komal Charitra | Licensing Program Analyst | Conducted the complaint investigation |
| Shirley Cheung | Care Coordination Director | Interviewed during the investigation |
| Armando Prado | Assistant General Manager | Interviewed during the investigation |
| Deborah Suarez | Assistant General Manager | Interviewed during the investigation |
Inspection Report
Complaint Investigation
Census: 101
Capacity: 260
Deficiencies: 0
May 10, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2023-03-28 regarding the facility being without hot water.
Findings
The investigation found that a maintenance staff accidentally punctured a hot water pipe causing no hot water for 4 days. The building engineer and contractors repaired the issue promptly, restoring hot water the same day. Water temperature tests and resident interviews confirmed hot water was adequate and daily routines were not interrupted. The allegation was deemed unsubstantiated due to lack of preponderance of evidence.
Complaint Details
Complaint was about the facility being without hot water. The allegation was investigated through interviews, water temperature testing, and record review. The complaint was found to be unsubstantiated.
Report Facts
Water temperature range during repair: 105
Water temperature range during repair: 118
Water temperature range from weekly log: 112
Water temperature range tested by LPA: 113
Number of residents interviewed: 5
Complaint received date: Mar 28, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Murial Han | Licensing Program Analyst | Conducted the complaint investigation and unannounced visit |
| Sarah Laloyan | Administrator | Facility administrator met during the investigation |
| Cara Smith | Licensing Program Manager | Reviewed and discussed the report |
Inspection Report
Complaint Investigation
Census: 101
Capacity: 260
Deficiencies: 0
May 10, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations regarding malfunctioning facility doors and unsafe accommodations related to those doors.
Findings
The investigation found that the 3rd floor and rooftop doors were functioning properly, and residents interviewed did not report concerns about the doors. The allegations were deemed unsubstantiated due to lack of evidence.
Complaint Details
The complaint alleged that facility doors were not in good repair, causing a resident to fall and be locked outside on the rooftop. The investigation included interviews with the resident, other residents, the building engineer, and a facility tour. The resident confirmed a fall unrelated to the doors and denied being locked out. The building engineer reported no prior issues and confirmed recent servicing of the rooftop door. The complaint was unsubstantiated.
Report Facts
Facility capacity: 260
Resident census: 101
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Murial Han | Licensing Program Analyst | Conducted the complaint investigation and facility tour |
| Sarah Laloyan | Administrator | Met with Licensing Program Analyst during the investigation |
| Cara Smith | Licensing Program Manager | Reviewed and discussed the report with the administrator |
Inspection Report
Complaint Investigation
Census: 101
Capacity: 260
Deficiencies: 1
May 10, 2023
Visit Reason
The visit was an unannounced case management incident follow-up conducted due to a reported incident where a resident (R1) left the memory care unit unattended after staff manually turned off the alarm on an egress door.
Findings
The facility was found deficient for staff manually turning off the alarm on an egress door, which allowed resident R1 to leave the facility unattended, posing an immediate health risk. The facility has since implemented corrective actions including providing a one-on-one sitter, staff in-service on elopement drills, and additional alarm devices.
Complaint Details
The visit was triggered by a complaint/incident report regarding resident R1 leaving the memory care unit unattended due to an alarm being manually turned off by staff. The deficiency was substantiated and cited under California Code of Regulations, Title 22, LIC 809D.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Staff manually turned off the alarm on one of the egress doors in the memory care unit, resulting in resident R1 leaving the facility unattended, posing an immediate health risk. | Type A |
Report Facts
Census: 101
Total Capacity: 260
Deficiency Count: 1
Plan of Correction Due Date: May 11, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Murial Han | Licensing Program Analyst | Conducted the inspection and authored the report |
| Sarah Laloyan | Administrator | Facility administrator met with the Licensing Program Analyst during the visit |
| Cara Smith | Licensing Program Manager | Supervisor named in the report and responsible for oversight |
Inspection Report
Complaint Investigation
Census: 92
Capacity: 260
Deficiencies: 1
Apr 6, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to address multiple allegations including failure to follow COVID-19 reporting, masking, testing, quarantining/isolation protocols, and ensuring residents received meals and mail in a timely manner.
Findings
The investigation substantiated that the facility failed to report staff COVID-19 positive cases during an outbreak from December 2022 to February 2023, violating reporting requirements. Other allegations regarding masking protocols, resident meal assistance, mail delivery, COVID-19 testing procedures, and isolation protocols were found to be unsubstantiated or unfounded.
Complaint Details
The complaint investigation was substantiated regarding failure to follow COVID-19 reporting protocols. The facility did not notify families, Community Care Licensing (CCL), and Local Public Health Department when staff tested positive for COVID-19 as required by Provider Notification Notices. Other allegations related to masking, meal assistance, mail delivery, testing, and isolation protocols were unsubstantiated or unfounded.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility did not report staff members who tested positive for COVID-19 during an outbreak on December 2022 - February 2023, posing potential health and safety risks to residents. | Type B |
Report Facts
Capacity: 260
Census: 92
Deficiency Plan of Correction Due Date: Apr 13, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarah Laloyan | Administrator | Named in relation to findings and interviews during the complaint investigation |
| Deborah Suarez | Assistant General Manager | Named in relation to findings and interviews during the complaint investigation |
| Murial Han | Licensing Program Analyst | Conducted the complaint investigation visit |
| Cara Smith | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Census: 22
Capacity: 260
Deficiencies: 0
Apr 18, 2022
Visit Reason
The visit was an unannounced case management incident to deliver the outcome of an incident reported on 3/29/2022 concerning resident #1 who was absent without official leave (AWOL).
Findings
The facility staff safely escorted the resident back after the resident left the facility unattended. No injuries occurred and no deficiencies were cited during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jen Johnson | National Care Director | Met with Licensing Program Analyst and discussed the incident involving resident #1. |
| Murial Han | Licensing Program Analyst | Conducted the unannounced visit and interviewed staff regarding the incident. |
Inspection Report
Census: 14
Capacity: 260
Deficiencies: 0
Mar 30, 2022
Visit Reason
An unannounced case management inspection was conducted regarding a self-reported incident where a resident left the facility without injury, reported on 2022-03-28.
Findings
The inspection involved gathering documentation and interviews related to the incident. Additional documents and staff interviews were requested for further follow-up.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jen Johnson | National Care Director | Met during inspection and interviewed regarding the incident. |
| Shirley Cheung | Care Coordinator Director | Met during inspection and interviewed regarding the incident. |
| Sarah Laloyan | Administrator | Joined the inspection shortly after it began. |
| Murial Han | Licensing Program Analyst | Conducted the inspection. |
| Julio Montes | Licensing Program Manager | Named in report header. |
Inspection Report
Original Licensing
Capacity: 260
Deficiencies: 0
Feb 23, 2022
Visit Reason
The visit was an announced Pre-Licensing inspection conducted to evaluate the facility for initial licensure and compliance with regulatory requirements.
Findings
The facility was observed to be spacious, clean, well-lit, and comfortable with no residents present during the inspection. Safety measures such as emergency exit plans, locked medication rooms, and controlled access to certain areas were noted. COVID-19 signage and PPE supplies were observed throughout the facility. Immediate licensure is recommended pending final approval.
Report Facts
Facility capacity: 260
Census: 0
Temperature range: 70
Temperature range: 76
Water temperature range: 106.2
Water temperature range: 118
Memory Care Unit rooms: 33
Memory Care Unit single apartments: 30
Memory Care Unit shared apartments: 3
Fire extinguisher and Ansel system inspection date: Dec 1, 2021
Elevator permit validity: Dec 2, 2021
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sarah Laloyan | Administrator | Met with Licensing Program Analyst during inspection and received orientation |
| Murial Han | Licensing Program Analyst | Conducted the Pre-Licensing inspection |
| Julio Montes | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Original Licensing
Capacity: 260
Deficiencies: 0
Jan 28, 2022
Visit Reason
The visit was an initial licensing evaluation of the Residential Care Facility for the Elderly to assess the applicant's understanding of California Code Title 22 regulations and readiness for licensing.
Findings
The applicant/administrator participated in a telephone interview (COMP II) confirming understanding of facility operation, admission policies, staffing requirements, restrictive health conditions, general provisions, emergency preparedness, complaints and reporting, and pre-licensing readiness. Identification was verified and required documentation was obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sirun Sarah Laloyan | Administrator | Applicant/administrator participating in licensing evaluation and interview |
| Jude De La Concepcion | Licensing Program Manager | Named in report header |
| Bethany Hunter | Licensing Program Analyst | Conducted and signed the licensing evaluation |
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