Facility Evaluation Report

On 9/17/2025 Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced to this facility to conduct a case management visit for the purpose of delivering an Order to Licensee/Facility of Immediate Exclusion from Facility. LPA initially met with staff on duty (S1 and S2), and explained the purpose of the visit. One of the facility manager, Apakuki Nawasa (S3), was notified and arrived shortly after.

Staff (S4) is excluded as a result unrelated to this facility.

LPA served notice of "ORDER TO LICENSEE/FACILITY OF IMMEDIATE EXCLUSION FROM FACILITY" for S4 who was not present at the time of visit. S3 was advised that an immediate removal is warranted and requested the Personnel Report (LIC500) and Guardian account be updated to remove S4 from the facility staff roster. A notice of completion shall be submitted to Community Care Licensing (CCL).

LPA informed S3 that S4 is not allowed to be employed and/or on any facility premises. The Order to Individual of Immediate Exclusion From All Facilities will be in effect as of 9/17/2025 upon receipt of the letter. A copy of the letter was given to the facility during this visit.

The facility understands this is an Immediate Exclusion and has agreed S4 cannot be allowed to work, live in, and/or have contact with residents in any residential facility licensed by the California Department of Social Services unless otherwise ordered by the Department.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed and cited.

Exit interview held with S3, and a copy of this report was provided.