Inspection Report
Annual Inspection
Census: 19
Capacity: 70
Deficiencies: 0
May 13, 2025
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 clean, well-maintained, and compliant with all applicable regulations. No deficiencies were cited during the visit.
Report Facts
Residents present: 19
Licensed capacity: 70
Emergency drill frequency: 4
Food supply duration: 2
Food supply duration: 7
Fire extinguisher last service date: Feb 27, 2025
Smoke detector test date: May 13, 2025
Resident files reviewed: 5
Staff personnel records reviewed: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Andrew Pence | Executive Director | Met with Licensing Program Analyst during inspection and participated in exit interview |
| Kiran Jain | Licensing Program Analyst | Conducted the inspection visit |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Original Licensing
Capacity: 70
Deficiencies: 0
May 2, 2024
Visit Reason
Prelicensing visit conducted to evaluate the facility for initial licensing and certification.
Findings
The prelicensing visit found no deficiencies. The Licensing Program Analyst toured the facility, reviewed key areas, and discussed the Component III presentation with the Executive Director.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the prelicensing visit and evaluation. |
| Grace Sandoval | Executive Director | Met with Licensing Program Analyst during the prelicensing visit and reviewed the Component III presentation. |
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