Senior Care Records.

Facility Evaluation Report

Ali Baba # 1, San Jose04/06/2023Licence 430700017

Capacity38
Date signed04/06/2023 12:05:20 PM
The inspector’s account

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct a Plan of Correction (POC) visit due to a POC that has not been submitted. LPA met with Licensee, Mustafa Sabankaya.

On 02/23/2023, the facility was issued a deficiency regarding incomplete records for residents needs and services plan. Part of the facility’s plan of correction (POC) was to submit a written plan and procedure to ensure current and new residents will have a written needs and services plan on file. Per request of the facility, the POC was extended until 04/01/2023.

On 03/30/2023, LPA Dolores received a call from the designated Administrator and during the call LPA provided a courtesy reminder of the POC due. Designated Administrator understood their POC was approaching and verbalized their plan of action. Designated Administrator was informed to send their plan and procedures in writing.

On 04/01/2023, the Department did not receive the facility’s plan of correction. On 04/03/2023, LPA followed-up with the Licensee and designated Administrator regarding the POC. On 04/05/2023, LPA received a response but still did not receive the POC.

A deficiency is being cited per California Code of Regulations, Title 22. See LIC809-D.

Exit interview was conducted with Licensee, Mustafa Sabankaya and a copy of the report was provided along with the appeal rights.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction