| Name: | ASHLEY MANOR, LLC |
| Jurisdiction: | Idaho |
| Legal type: | Limited Liability Company (D) |
| Status: | Active-Existing |
| Date of registration: | 27 Jun 2001 (24 years ago) |
| Financial Date End: | 30 Jun 2025 |
| Entity Number: | 61305 |
| Place of Formation: | IDAHO |
| File Number: | 61305 |
| Principal Address: | PO BOX 1176 MERIDIAN, ID 83680 |
| Mailing Address: | PO BOX 1176 MERIDIAN, ID 83680-1176 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASHLEY MANOR, LLC 401(K) PLAN | 2021 | 155671934 | 2023-09-12 | ASHLEY MANOR, LLC | 431 | |||||||||||||||||||||||||||||||||||||||||
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| Active participants | 226 |
| Retired or separated participants receiving benefits | 121 |
| Number of participants with account balances as of the end of the plan year | 204 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 113 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-12 |
| Name of individual signing | JASON EBERHARD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-09-12 |
| Name of individual signing | JASON EBERHARD |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083767298 |
| Plan sponsor’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
Plan administrator’s name and address
| Administrator’s EIN | 155671934 |
| Plan administrator’s name | ASHLEY MANOR, LLC |
| Plan administrator’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
| Administrator’s telephone number | 2083767298 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-04 |
| Name of individual signing | KEITH FLETCHER |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-04 |
| Name of individual signing | KEITH FLETCHER |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083767298 |
| Plan sponsor’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
Plan administrator’s name and address
| Administrator’s EIN | 155671934 |
| Plan administrator’s name | ASHLEY MANOR, LLC |
| Plan administrator’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
| Administrator’s telephone number | 2083767298 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2010-10-04 |
| Name of individual signing | KEITH FLETCHER |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2083767298 |
| Plan sponsor’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
Plan administrator’s name and address
| Administrator’s EIN | 155671934 |
| Plan administrator’s name | ASHLEY MANOR, LLC |
| Plan administrator’s address | 3749 N. CLOVERDALE, BOISE, ID, 83713 |
| Administrator’s telephone number | 2083767298 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-04 |
| Name of individual signing | KEITH FLETCHER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-04 |
| Name of individual signing | KEITH FLETCHER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| JASON R FLETCHER | Agent | 4334 N BRIGHT ANGEL AVE, MERIDIAN, ID 83646 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| KEYSTONE WEST INC | Manager | PO BOX 1176, MERIDIAN, ID 83680 | 2021-05-05 |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Change of Registered Office/Agent/Both (by Entity) | 0005744051 | 2024-05-30 |
| Annual Report | 0005721926 | 2024-05-03 |
| Annual Report | 0005225357 | 2023-05-05 |
| Annual Report | 0004733518 | 2022-05-04 |
| Change of Registered Office/Agent/Both (by Entity) | 0004379663 | 2021-08-11 |
| Annual Report | 0004273524 | 2021-05-05 |
| Annual Report | 0003856387 | 2020-05-01 |
| Annual Report | 0003531645 | 2019-06-05 |
| Annual Report | 0001152934 | 2018-06-26 |
| Annual Report | 0001152933 | 2017-05-01 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BPA | AWARD | VA531C99179 | 2008-06-12 | 2012-09-30 | No data | |||||||||||||||||||||||
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| Title | NON PERSONAL SERVICE TO PROVIDE RESPITE AND ADULT DAY CARE SERVICES TO THE VETERANS OF THE VA MEDICAL CENTER BOISE |
| NAICS Code | 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES |
| Product and Service Codes | R401: PERSONAL CARE SERVICES |
Recipient Details
| Recipient | ASHLEY MANOR, LLC |
| UEI | SLANJ48Y3HX3 |
| Legacy DUNS | 801366647 |
| Recipient Address | 3749 N CLOVERDALE RD, BOISE, 837133610, UNITED STATES |
| Unique Award Key | CONT_IDV_VA260BP0026_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 150000.00 |
Description
| Title | BLANKET PURCHASE AGREEMENT FOR ADULT DAY CARE SERVICES |
| NAICS Code | 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES |
| Product and Service Codes | R401: PERSONAL CARE SERVICES |
Recipient Details
| Recipient | ASHLEY MANOR, LLC |
| UEI | SLANJ48Y3HX3 |
| Recipient Address | 3749 N CLOVERDALE RD, BOISE, ADA, IDAHO, 837133610, UNITED STATES |
| Unique Award Key | CONT_AWD_VA531C89242_3600_VA260BP0026_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | ADULT SERVICE |
| NAICS Code | 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES |
| Product and Service Codes | R401: PERSONAL CARE SERVICES |
Recipient Details
| Recipient | ASHLEY MANOR, LLC |
| UEI | SLANJ48Y3HX3 |
| Legacy DUNS | 801366647 |
| Recipient Address | 3749 N CLOVERDALE RD, BOISE, 837133610, UNITED STATES |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 346046287 | 1032500 | 2022-06-28 | 11099 W HIGHMONT DR., BOISE, ID, 83709 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Complaint |
| Activity Nr | 1910763 |
| Health | Yes |
Violation Items
| Citation ID | 01001A |
| Citaton Type | Serious |
| Standard Cited | 19100134 C01 II |
| Issuance Date | 2022-11-28 |
| Abatement Due Date | 2022-12-22 |
| Current Penalty | 7925.0 |
| Initial Penalty | 7925.0 |
| Final Order | 2022-12-27 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Related Event Code (REC) | Complaint |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(c)(1)(ii):The written program did not contain provisions for medical evaluations of employees required to use respirators: a) Residential Care Home: On June 28, 2022 and at times prior to; employees required to wear an N95 respirator had not been medically evaluated. Note* Abatement certification IS required for this item. |
| Citation ID | 01001B |
| Citaton Type | Serious |
| Standard Cited | 19100134 C01 III |
| Issuance Date | 2022-11-28 |
| Abatement Due Date | 2022-12-22 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2022-12-27 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(c)(1)(iii): The written program did not contain fit test procedures for tight-fitting respirators: a) Residential Care Home: On June 28, 2022 and at times prior to; employees were required to wear an N95 respirator if they were employed in a home where residents or other care providers were positive for COVID-19. Note* Abatement certification IS required for this item. |
| Citation ID | 01001C |
| Citaton Type | Serious |
| Standard Cited | 19100134 F02 |
| Issuance Date | 2022-11-28 |
| Abatement Due Date | 2022-12-22 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2022-12-27 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.134(f)(2): Employee(s) using tight-fitting facepiece respirators were not fit tested prior to initial use of the respirator: a) Residential Care Home: On June 28, 2022 and at times prior to; employees required to wear an N95 respirator had not been fit tested before working with COVID-19 positive residents. Note* Abatement certification IS required for this item. |
| Inspection Type | Complaint |
| Scope | Partial |
| Safety/Health | Health |
| Close Conference | 2006-03-15 |
| Emphasis | N: NURSING |
| Case Closed | 2006-12-22 |
Related Activity
| Type | Complaint |
| Activity Nr | 200241164 |
| Safety | Yes |
| Health | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19040030 A |
| Issuance Date | 2006-03-27 |
| Abatement Due Date | 2006-04-13 |
| Nr Instances | 1 |
| Nr Exposed | 7 |
| Gravity | 00 |
| Citation ID | 01002 |
| Citaton Type | Other |
| Standard Cited | 19040032 B06 |
| Issuance Date | 2006-03-27 |
| Abatement Due Date | 2006-04-13 |
| Nr Instances | 1 |
| Nr Exposed | 7 |
| Gravity | 00 |
| Inspection Type | Complaint |
| Scope | Partial |
| Safety/Health | Safety |
| Close Conference | 2006-03-15 |
| Emphasis | N: NURSING |
| Case Closed | 2007-01-29 |
Related Activity
| Type | Complaint |
| Activity Nr | 200241164 |
| Safety | Yes |
| Health | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19100037 B01 |
| Issuance Date | 2006-03-27 |
| Abatement Due Date | 2006-04-13 |
| Nr Instances | 2 |
| Nr Exposed | 7 |
| Gravity | 01 |
| Citation ID | 01002 |
| Citaton Type | Other |
| Standard Cited | 19100037 B02 |
| Issuance Date | 2006-03-27 |
| Abatement Due Date | 2006-04-13 |
| Nr Instances | 2 |
| Nr Exposed | 7 |
| Gravity | 01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1444628408 | 2021-02-02 | 1087 | PPP | 4334 N Bright Angel Ave, Meridian, ID, 83646-3611 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 30 Mar 2025
Sources: Idaho Secretary of State
