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Inspection visit

Routine inspection

EBADAT RESIDENTIAL CARE HOME #4License 4352024032 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Steve Chang arrived unannounced to conduct the facility's annual inspection. LPA met with Licensee, Hassan Ebadat (LCN). LPA toured the facility inside and out with LCN. 2 staff and 2 residents were observed in the facility. 3 residents went to day program. Facility license, Administrator Certificate and Personal Rights posters were observed in the facility. LPA reviewed 3 resident files and 3 staff files. LPA toured the facility to include the living room, dining room, kitchen, resident bedrooms, bathroom, garage, and backyard. All fire exit routes were free and clear of obstruction. All staff present are fingerprint cleared and associated to the facility. Facility temperature maintained at 71 degrees Fahrenheit. Hot water temperature maintained at 106 degrees Fahrenheit. Facility's fire extinguisher last serviced on 04/6/2023. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet Knives closet, and cleaning product closet were observed locked. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Fire alarm and smoke detectors were tested by ADM. The fire alarm and smoke detectors were working fine. Flash lights and first aid box were observed in the facility. The last time the facility conducted the emergency and fire drill was 2/20/2024. Deficiencies noted today. See 809-D. Exit interview was conducted with LCN. The report was provided to LCN for signature. A copy of the report was provided to LCN.

Citations

2 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87507(c)Type B

    Based on record review, the licensee did not comply with the section cited above in that 2 out of 3 residents' admission agreements were not signed by the family and the facility staff which poses/posed a potential health, safety or personal rights risk to persons in care.

  • 87463(a)Type B

    Based on record review, the licensee did not comply with the section cited above in that 2 out of 3 residents' Appraisal Needs and Service plan were not signed by the facility and the facility staff which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the March 6, 2024 inspection of EBADAT RESIDENTIAL CARE HOME #4?

This was a inspection inspection of EBADAT RESIDENTIAL CARE HOME #4 on March 6, 2024. 2 citations were issued: 2 Type B.

Were any citations issued to EBADAT RESIDENTIAL CARE HOME #4 on March 6, 2024?

Yes, 2 citations were issued (0 Type A, 2 Type B). The first citation was for: "Based on record review, the licensee did not comply with the section cited above in that 2 out of 3 residents' admission..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.