Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 5/3/22 at 1:00pm. This visit is to confirm ORDERS TO INDIVIDUAL FOR IMMEDIATE EXCLUSION FROM ALL FACILITIES.

LPA was met by Lusiana Bulameicabai , Caregiver and stated the purpose of the visit. LPA spoke with Administrator Bianca Castro who stated S1 never worked at this facility. S1 was not present at the time of visit.

Facility understands this is an Immediate Exclusion effective 4/14/2022. S1 is excluded and prohibited from being a licensee, owning a beneficial ownership of 10% interest or more in a licensed facility, or being an Administrator, officer, director, member, or manager of a licensee or entity controlling a licensee. S1 cannot be allowed to work, live in, and/or have contact with clients in any residential facility licensed by the California Department of Social Services.

Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies were observed and cited. Exit interview held, Copy of report given