Nick's Maple Home Ii

Operated Facilities:(a) In addition to the rights listed in Section 87468.1,.. personal rights: (4) To care, supervision, and services that meet their individual needs and are...their needs. This requirement is not met as evidenced by: On December 1, 2025, LPA arrived unannounced to the facility and observed the facility did not have any staff present in the facility, residents were left unsupervised and facility keys were left and unsecured which poses a health and safety risk for residents in care.

Based on observation, and record review, the licensee did not comply with the section cited above by not ensuring the facility maintained a annual needs and service plan for 1 out of 3 residents in care which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, and record review, the licensee did not comply with the section cited by not ensuring that all staff records are updated and maintained. LPA observed that 6 out of 7 staff were missing proof of criminal clearance, health screening/TB test, training, or CPR which poses an immediate health, safety or personal rights risk to persons in care.

Based on observation, the licensee did not comply with the section cited above by not monitoring and maintaining the water temperature. LPA observed the water temperature measured at 133.4, 134.3, and 156.6 degrees Fahrenheit which poses/posed a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the assistant administrator did not comply with the section cited above by not having a facility fully staffed with staff present at all times which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview, and record review, the assistant administrator did not comply with the section cited above by not having the residents records updated and complete which poses a potential health, safety or personal rights risk to persons in care.

Based on observation, interview and record review, the assistant administrator did not comply with the section cited above by not encouraging residents to participate in activities due to the activities schedule was not being followed which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the assistant administrator did not comply with the section cited above by not having the facility safe and in good repair which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the assistant administrator did not comply with the section cited above in providing an appropriate sized bed for the couple which poses a potential health, safety or personal rights risk to persons in care.

Based on observation and interview, the assistant administrator did not comply with the section cited above by providing sanitary pads which poses a potential health, safety or personal rights risk to persons in care.

Based on observations made in the fcaility's backyard the licensee did not comply with the section cited above in by not ensuring dangerous items were secured and inaccessible to residents; which poses an immediate health, safety or personal rights risk to persons in care.

87211 Reporting Requirements - (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (2) Occurrences,... which threaten the welfare, safety or health of residents... shall be reported within 24 hours either by telephone or facsimile to the licensing agency...This requirement is not met as evidenced by:Based on observations and review of records, the Administrator failed to report 2 special/unusual incident reports to the licensing office within the required timeframe.

80022 Plan of Operation - Sample menus and a schedule for one calendar week indicating the time of day that meals and snacks are to be served.This requirement was not met as evidenced by: Based on observations, Adminsitrator failed to post/maintain a facility food menu. When LPA requested to view the food menu, the menu could not be produced. This poses a potential Health, Safety and Personal Rights Risk to persons in care.

87309 Storage Space (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This requirement was not met as evidenced by:Based on observations and interviews, Administrator failed to ensure that all chemicals and other dangerous items were not secure. LPA observed two open sheds in the facility's backyard. Sheds contained yard tools and chemicals/toxins accessible to residents in care. This poses a potential Health, Safety and Personal Rights risk to persons in care.

80072 Personal Rights - ....each client shall have personal rights which include, but are not limited to, the following:(3) To be free from corporal or unusual punishment, ...or other actions of a punitive nature, including but not limited tofunctions, including eating...This requirement was not met as evidenced by: Based on observations and interviews the Administrator prevents residents access to the food supply during the evenings by keeping the pantries and refridgerator locked which poses an immediate Health, Safety and Personal Rights risk to persons in care.

80069 Client Medical Assessment The assessment shall be performed by a licensed physician or designee, who is also a licensed professional, and the assessment shall not be more than one year old when obtained.This requirement is not met as evidenced by: Based on a review of records, Administrator failed to obtain and maintain R1's Physician's report within 1 year which poses a potential Health, Safety, and/or personal rights risk to persons in care.

Plan of Operation - (a) Each licensee shall have and maintain on file a current, written, definitive plan of operation. (5) Staffing plan, qualifications and duties, if applicable. Based on observation and staff interviews, Administrator failed to have the staffing schedule posted or made available to Licensing Staff during the visit.

80076 Food Services(4) Between meal nourishment or snacks shall be available for all clients unless limited by dietary restrictions prescribed by a physician.This requirement is not met as evidenced by: Based on observation the licenseedid not provide residents with acecess to their food supply which poses an immediate Health, Safety and Personal Rights risk to persons in care.