Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Jul 22, 2025
Visit Reason
The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was found to be in full compliance with no deficiencies cited. The inspection included a tour of the facility, review of emergency and infection control plans, and verification of safety equipment and supplies.
Report Facts
PPE supply duration: 30
Perishable food supply duration: 2
Non-perishable food supply duration: 7
Fire extinguisher purchase date: Apr 9, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Navdeep Kaur | Administrator | Met during inspection and infection control leader |
| Daisy Panlilio | Licensing Program Analyst | Conducted the inspection |
| Bennett Fong | Licensing Program Manager | Named in report |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
May 16, 2024
Visit Reason
The visit was an unannounced annual required inspection conducted by the Licensing Program Analyst to evaluate compliance with regulatory requirements.
Findings
The facility was found to be in compliance with no deficiencies cited. The inspection included a tour of the facility, review of staff and resident files, and verification of emergency and infection control plans.
Report Facts
Administrator certificate expiration: May 20, 2024
Fire extinguisher last inspection date: Apr 18, 2024
Hot water temperature: 114
Facility temperature: 79
Food supply duration: 2
Food supply duration: 7
PPE supply duration: 30
Staff files reviewed: 4
Resident files reviewed: 5
Staff interviews conducted: 2
Resident interviews conducted: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Navdeep Kaur | Administrator | Met with Licensing Program Analyst during inspection and identified as infection control leader |
| Jessica Balite | Caregiver | Met with Licensing Program Analyst during inspection |
| Daisy Panlilio | Licensing Program Analyst | Conducted the inspection visit |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Jul 7, 2023
Visit Reason
The visit was an unannounced annual required inspection conducted by the Licensing Program Analyst to evaluate the facility's compliance with regulatory standards.
Findings
The inspection found no deficiencies. The facility was toured, and various safety, infection control, and emergency preparedness measures were verified. Staff and resident files were reviewed, and interviews were conducted.
Report Facts
Food supply duration: 2
Food supply duration: 7
PPE supply duration: 30
Hot water temperature: 116
Facility temperature: 76
Staff files reviewed: 5
Resident files reviewed: 5
Staff interviews conducted: 2
Resident interviews conducted: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Navdeep Kaur | Administrator | Met during inspection and identified as infection control leader |
| Daisy Panlilio | Licensing Program Analyst | Conducted the inspection visit |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 0
May 18, 2022
Visit Reason
The visit was an unannounced required 1-year infection control inspection conducted to evaluate the facility's compliance with infection control policies and procedures.
Findings
The inspection found that the facility had appropriate infection control measures in place, including screening stations, signage, PPE supplies, and staff compliance with mask-wearing. No deficiencies were cited during the visit.
Report Facts
Capacity: 6
Census: 3
PPE supply duration: 30
Food supply duration - perishable: 2
Food supply duration - non-perishable: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Navdeep Kaur | Administrator | Administrator authorized staff to act on her behalf and is the infection control leader |
| Daisy Panlilio | Licensing Program Analyst | Conducted the infection control inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
May 18, 2021
Visit Reason
The visit was an unannounced required annual infection control inspection conducted to evaluate compliance with COVID-19 mitigation and infection control practices.
Findings
The facility was found to be in compliance with infection control practices, including proper use of PPE, symptom screening, social distancing, and emergency preparedness. No deficiencies were cited during the visit.
Report Facts
Capacity: 6
Census: 4
Emergency food supplies: 7
Emergency food supplies: 2
Administrator onsite hours: 20
Facility room temperature: 74
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Navdeep Kaur | Administrator | Administrator and infection control designated leader |
| Daisy Panlilio | Licensing Program Analyst | Conducted the inspection |
| Bennett Fong | Licensing Program Manager | Named in report header |
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