Inspection Reports for Grand River Villa
509 Michigan Blvd, West Sacramento, CA 95691, CA, 95691
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Inspection Report
Annual Inspection
Census: 23
Capacity: 43
Deficiencies: 0
Jul 14, 2025
Visit Reason
The visit occurred as an unannounced annual inspection to evaluate compliance with licensing requirements at the facility.
Findings
The facility was found to be clean, well organized, and in compliance with regulations including kitchen safety, resident room conditions, water temperature, medication storage, and fire safety. No deficiencies were cited during the inspection.
Report Facts
Residents present: 25
Caregivers present: 2
Med tech present: 1
Fire extinguisher last charged: Nov 23, 2024
Last fire drill date: Apr 15, 2025
Last fire inspection date: Jun 9, 2025
Water temperature range: 115.3-116.9
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Magda Luis | Administrator | Met with during inspection and discussed First Aid/CPR training |
| Jill Nakagawa | Licensing Program Analyst | Conducted the inspection visit |
| Maria Ortiz | Resident Care Coordinator | Greeted the Licensing Program Analyst upon arrival |
Inspection Report
Follow-Up
Census: 29
Capacity: 43
Deficiencies: 0
Nov 14, 2024
Visit Reason
The visit was conducted to follow up on the plan of correction for a previous deficiency and to perform a health and safety check.
Findings
The facility's kitchen was inspected and found to have an ample supply of perishable and non-perishable foods as required. The plan of correction for the deficiency cited on 11/05/2024 has been met, and no new deficiencies were cited.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria Ortiz | Resident Care Coordinator | Met during inspection and participated in exit interview. |
| Robert Godfrey | Administrator | Facility Administrator, participated via phone during inspection. |
| Jill Nakagawa | Licensing Program Analyst | Conducted the inspection visit. |
Inspection Report
Original Licensing
Census: 29
Capacity: 43
Deficiencies: 1
Nov 5, 2024
Visit Reason
The inspection was an unannounced Post-Licensing visit conducted to evaluate compliance with licensing requirements for Grand River Villa.
Findings
The facility was generally well-maintained with appropriate safety features and furnishings. However, a deficiency was cited for failing to maintain an adequate supply of perishable and non-perishable foods as required by regulation.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure adequate perishable and non-perishable foods available for the required time frame for a minimum of 29 residents. | Type B |
Report Facts
Residents present: 29
Total capacity: 43
Deficiencies cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jill Nakagawa | Licensing Program Analyst | Conducted the inspection and authored the report |
| Maria Ortiz | Resident Care Coordinator | Met with the Licensing Program Analyst during the inspection |
| Kimberley Mota | Licensing Program Manager | Supervisor and Licensing Program Manager overseeing the inspection |
Inspection Report
Original Licensing
Census: 27
Capacity: 43
Deficiencies: 0
Jul 29, 2024
Visit Reason
The inspection was an unannounced pre-licensing visit to evaluate Grand River Villa for initial licensing as a Resident Care Facility for the Elderly.
Findings
The facility met all requirements under Title 22, California Code of Regulations, with no deficiencies cited. The environment was clean, safe, and well-equipped, and required postings were observed. Resident and employee files were complete.
Report Facts
Residents present: 27
Total licensed capacity: 43
Fire clearance capacity: 43
Rooms: 23
Fire extinguisher last inspection date: Oct 18, 2023
Water temperature range: 112-116
Resident files reviewed: 3
Employee files reviewed: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Paz | Administrator | Met via phone during inspection and mentioned in relation to facility operations |
| Jill Nakagawa | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Kimberley Mota | Licensing Program Manager | Named as Licensing Program Manager overseeing the report |
Inspection Report
Original Licensing
Census: 27
Capacity: 43
Deficiencies: 0
Jul 15, 2024
Visit Reason
The visit was conducted as a pre-licensing readiness evaluation and COMP II interview to verify the applicant/administrator's understanding of community care facility licensing laws and readiness for licensing.
Findings
The applicant/administrator demonstrated understanding of licensing laws, facility operation, medication storage, fire drills, transportation, and filling vacancies. Identification was verified and required documentation was obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Diana Paz | Administrator | Applicant/administrator participating in COMP II interview and verification |
| Mark Cimino | Member | Participant in COMP II interview |
| Julia Kim | Licensing Program Manager | Named in report header and signature section |
| Dianne Ramos | Licensing Program Analyst | Named in report header and signature section |
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