Facility Evaluation Report

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

Capacity38
Date signed04/06/2023 12:07:14 PM
The inspector’s account

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct a case management - other visit. LPA met with Licensee, Mustafa Sabankaya. The purpose of the visit is to issue a civil penalty regarding a staff working in the facility without obtaining a criminal record clearance or criminal record exemption prior to starting work.

On 03/23/2023, the Department received a letter from Care Provider Management Bureau (CPMB) of a prospective employee (S1) criminal record exemption needed letter that was returned to the Department due to an incorrect facility mailing address. On 03/24/2023, LPA Dolores emailed the facility manager and Licensee the CPMB document. Upon a telephone call from the facility, it was found the individual (S1) was working with residents in the facility from October 2022 – December 2022 without obtaining a criminal record clearance / exemption. Based record review, the individual completed a live scan on 09/13/2022. The Licensee did not receive a criminal background clearance letter from the Department prior to the individual starting work. The individual’s last day at the facility was in November 7, 2022.

Documents were obtained to include S1's live scan form and timecard from October 2022 - November 2022.

A deficiency is being cited per California Code of Regulations, Title 22. See LIC809-D. A civil penalty is being assessed for the amount of $500 ($100 per day x 5 days = $500) for staff (S1) working at the facility without fingerprint clearance. See LIC421BG.

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