Ebadat Residential Care Home #6

Based on observation & record review, the licensee did not comply with the section cited above. Based on observation, facility shed in the backyard. LPA noted there was a mattress, cloths, medications, with a power cord inside.LPA also noted there was a fan, a heater pointed towards the bed. ADM confirmed there is a staff who sleeps in the shed. which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation,interview, record review, the licensee did not comply with the section cited above. Based on observation, the facility office and sitting room does not reflect the current facility fire cleareance. LN confirmed he did add a partition wall in the sitting room. LN confirmed the additional bedroom in the office does not have a permit. This poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above. S1's health screening did not have the evaluation of general health/ evaluation of ability to preform work / note any health condition/ the physician's stamp/signature. ADM stated S1 would get a new updated health screening in 1 week. which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review, the licensee did not comply with the section cited above. Based on a review of the facility's disaster drill log, the last drill conducted was on August 20, 2024. This poses/posed a potential health, safety or personal rights risk to persons in care.

87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency... reports... (1) A written report shall be submitted to the licensing agency and to the person responsible…within seven days of the occurrence...(D)Any incident which threatens the welfare, Based on the interview and record review, DADM stated that incident report of R1s elopement incident on 1/15/25 was not submitted to CCLD and to person responsible for resident within 7 days, which pose/poses a health, safety & personal rights risk to persons in care.

87355 Criminal Record Clearance (e) All individuals...pursuant to Health and Safety Code Section 1569.17(b) shall prior to working... in a licensed facility: (2)Request a transfer of a criminal record clearance...This section is not met as evidenced by: Based on interview & record review, DADM stated S2 started working at the facility on 2/28/2025 and application to transfer or associate S2 has was not submitted to CCLD prior to S2 working at the facility which pose/poses an immediate health and personal right risks to persons in care.

Based on record review, the licensee did not transfer criminal record clearance of S5 from one facility to another. S5 was observed providing care and supervision to residents in care which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on record review the licensee did not by not completing, maintaining the record of 3 out of 6 resident records. 2 out 3 (R1 to R3) were missing consent form, appraisal needs and services plan. R1 to R3 are missing information on the personal rights document. R1-R3 are missing information on the emergency ID. R3 is missing the second page of the physicians medical report, which poses/posed a potential health, safety or personal rights risk to persons in care.