Inspection Report
Annual Inspection
Census: 49
Capacity: 54
Deficiencies: 0
Jul 3, 2025
Visit Reason
The visit was a Case Management - Annual Continuation inspection conducted as a continuation of the Annual inspection visit that occurred on 2025-06-16.
Findings
The Licensing Program Analyst reviewed staff and resident records and confirmed compliance with required documentation. No deficiencies were cited during the visit.
Report Facts
Staff personnel records reviewed: 6
Resident records reviewed: 5
Residents with required documentation: 5
Staff members with required documentation: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tim Selleck | Executive Director | Met with Licensing Program Analyst during the inspection and named in the report |
| Kiran Jain | Licensing Program Analyst | Conducted the inspection visit |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 49
Capacity: 54
Deficiencies: 0
Jun 16, 2025
Visit Reason
The inspection was an unannounced Required 1-Year Annual inspection conducted to evaluate the facility's compliance with licensing requirements.
Findings
The facility was found to be clean, well-maintained, and compliant with all inspected areas including resident apartments, kitchen, fire safety equipment, medication storage, and common areas. No deficiencies were cited during the visit.
Report Facts
Levels in building: 6
Resident apartments inspected: 5
Hot water temperature range: 108.4
Hot water temperature range: 112.6
Days of fresh perishable food supply: 2
Days of nonperishable staples supply: 7
Last fire extinguisher service date: Jan 8, 2025
Last fire alarm/smoke detector service date: Apr 2, 2025
Last fire sprinkler service date: May 21, 2025
Last emergency drill date: May 14, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tim Selleck | Executive Director | Met with Licensing Program Analyst during inspection and named in exit interview. |
| Kiran Jain | Licensing Program Analyst | Conducted the inspection and signed the report. |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 42
Capacity: 54
Deficiencies: 2
Jun 19, 2024
Visit Reason
The inspection was an unannounced required 1 Year visit to evaluate compliance with licensing regulations.
Findings
Deficiencies were cited related to missing current first aid certifications for some staff and incomplete centrally stored medication records for residents. An advisory note was also issued.
Deficiencies (2)
| Description |
|---|
| Three out of six reviewed staff records were missing current first aid certifications, posing a potential safety risk. |
| Five out of five reviewed resident Centrally Stored Medication and Destruction Records (CSMDR) had prescription medications missing from the records, posing a potential health risk. |
Report Facts
Staff records missing first aid certifications: 3
Resident medication records missing entries: 5
Facility capacity: 54
Facility census: 42
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Kris Vu | Director of Resident Health Services | Met with the Licensing Program Analyst during the inspection |
| Sarah Yip | Licensing Program Manager | Supervisor for the inspection |
Inspection Report
Complaint Investigation
Census: 33
Capacity: 54
Deficiencies: 0
Aug 3, 2022
Visit Reason
The visit was conducted as a Case Management visit in response to a Suspected Adult/Elderly Abuse form submitted by the facility alleging that staff S1 verbally abused resident R1.
Findings
During the visit, multiple residents and staff were interviewed, and relevant records were reviewed. The facility conducted an internal investigation and implemented a response plan to have another staff accompany S1 when assisting R1. No deficiencies were cited at this time.
Complaint Details
The complaint involved an allegation of verbal abuse by staff S1 towards resident R1. The complaint was investigated through interviews and record reviews, and the facility implemented a response plan. No deficiencies were cited.
Report Facts
Capacity: 54
Census: 33
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tim Selleck | Administrator | Met with Licensing Program Analyst during the visit and involved in the investigation |
| David Marrufo | Licensing Program Analyst | Conducted the unannounced Case Management visit and investigation |
Inspection Report
Annual Inspection
Census: 28
Capacity: 54
Deficiencies: 0
Jul 27, 2022
Visit Reason
An unannounced Required 1 Year visit was conducted to evaluate the facility's compliance with regulations.
Findings
The Licensing Program Analyst toured the facility and observed adequate visitor screening, PPE supplies, and food supplies. No deficiencies were cited during this inspection.
Report Facts
PPE supply duration: 30
Perishable food supply duration: 2
Non-perishable food supply duration: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Marrufo | Licensing Program Analyst | Conducted the inspection and observed facility conditions |
| Ann Lee | Met with the Licensing Program Analyst during the visit |
Inspection Report
Annual Inspection
Census: 41
Capacity: 54
Deficiencies: 0
Jun 7, 2021
Visit Reason
An unannounced COVID-19 Infection Control Required 1 Year visit was conducted to evaluate the facility's compliance with infection control regulations.
Findings
No deficiencies were cited during the inspection. The facility was observed to have adequate PPE supplies and staff were wearing masks, although bathrooms lacked trash cans with foot-operated lids.
Report Facts
Capacity: 54
Census: 41
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Hibbs | Administrator | Met with Licensing Program Analyst during the inspection |
| David Marrufo | Licensing Program Analyst | Conducted the inspection |
Inspection Report
Routine
Census: 41
Capacity: 54
Deficiencies: 0
May 3, 2021
Visit Reason
The visit was a tele-visit conducted to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility.
Findings
No deficiencies were cited during the visit. Recommendations were made to continue facility COVID-19 mitigation practices.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Linda Hibbs | Administrator | Met with Licensing Program Analyst and Nurse during the tele-visit. |
| David Marrufo | Licensing Program Analyst | Conducted tele-visit and provided technical assistance. |
| Roxane Fangon | Nurse | Provided recommendations during the tele-visit. |
Loading inspection reports...
