430700017-8-16-2023-26-AS-KHOS-CV5J8B-20230828064912

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430700017
Report Date: 08/16/2023
Date Signed: 08/16/2023 11:49:03 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/17/2020 and conducted by Evaluator David Marrufo

COMPLAINT CONTROL NUMBER: 26-AS-20201117155339

FACILITY NAME:	ALI BABA # 1		FACILITY NUMBER:	430700017
ADMINISTRATOR:	CHERALYNN SABANKAYA		FACILITY TYPE:	735
ADDRESS:	260 SOUTH 11TH STREET		TELEPHONE:	(408) 289-1644
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	38	CENSUS: 41	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Maria Canizales		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff withheld resident's mail.
Resident is not allowed to receive an assessment.
Staff bribed resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced complaint investigation visit and met with Maria Canizales.

The Department conducted complaint investigation visits to the facility on 11/30/2020 and 07/27/2023.

On 11/30/2020, LPA Marrufo interviewed 8 residents, 3 staff and facility Licensee Mustafa Sabankaya. 8 out of 8 interviewed residents stated to have never observed any times when staff withheld their mail, didn’t allow them to have an assessment done, or bribed them. 3 out of 3 staff stated to have not observed any times when staff withheld resident’s mail, prevented residents from having an assessment done, or bribed a resident. Licensee Sabankaya stated during interview that staff have not withheld mail from residents, staff have not kept residents from having an assessment done, and no residents have been bribed.

See LIC9099-C for more information. Page 1 of 2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 26-AS-20201117155339

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: ALI BABA # 1	FACILITY NUMBER: 430700017
	VISIT DATE: 08/16/2023

NARRATIVE

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On 07/23/2023, the LPAs Grace Donato and Manuel Monter interviewed 4 residents. 4 out of 4 interviewed residents stated to not have observed staff withholding their mail or bribe them. 4 out of 4 interviewed residents stated to have never had staff prevent them from receiving an assessment. 1 out of 4 interviewed residents stated to not remember if staff prevented residents from receiving an assessment.

On 08/14/2023, LPA Marrufo interviewed 2 witnesses. 1 out of 2 witnesses stated to not know if staff withheld mail from residents and the other witness stated to have not observed staff withholding mail from residents. 2 out of 2 interviewed witnesses stated to have not observed staff not allowing residents to receive an assessment. 1 out of 2 witnesses stated that a resident completed chores at the facility and was rewarded $25 a week for completing the chores.

Based on information from interviews conducted with staff, and records reviewed, although the allegations listed above may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are unsubstantiated.

No Deficiencies were cited under California Code of Regulations Title 22

This report was reviewed with Maria Canizales and a copy of this report was provided.

Page 2 of 2. END REPORT.

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2