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In the 1906 earthquake, the main treatment building collapsed
, crushing 112 residents and staff under a pile of rubble. The victims were buried in a mass grave on the asylum cemetery grounds. The Institution was then redesigned with low-rise buildings that resembled a college campus. According to the information from DDS there are 607 documented burials here from 1889-1906. Burials continued at the hospital through the 1960s.