Facility Evaluation Report

On August 28, 2025, Licensing Program Analyst (LPA) Cassie Yang conducted unannounced case management visit. LPA met with caregiver who stated Administrator is not at the facility at this time. When asked, LPA was informed Administrator has not been at the facility since last week. This visit is to deliver in-person of ORDER TO LICENSEE/FACILITY OF IMMEDIATE EXCLUSION FROM FACILITY.

Facility understands this is an Immediate Exclusion and S1 is excluded and 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. Therefore, the Department orders the facility to remove S1 from any contact with clients and not allow this employee to be physically present in the facility.

Exit interview conducted, a copy of this report provided on this date. A signature on these forms acknowledges receipt of these forms.