Follow-up on corrections·November 3, 2023

Licensing Program Analyst, Amber Coleman, (LPA) arrived at Nick’s Maple Home II to conduct an unannounced complaint visit for #56-AS-20230426113048 & 56-AS-20231101125452 During visit, LPA observed deficiencies not related to the complaint allegations. LPA reviewed two, (2) resident files. 2 out of 2 resident files were incomplete. LPA observed that R1’s Physician’s Report was out of date. LPA observed that the date printed on the Physician’s Report was 1/7/2021. R2's resident file was missing the Physician's Report. Administrator agreed to contact R2's Medical Offices to have the Physician's Report completed. At approximately, 1:35pm LPA walked through the facility's backyard. Upon exiting the facility through the sliding doors, laid a an orange water hose. LPA observed a shovel and a rake leaned up against the side wall of the facility. LPA observed another rake leaned up against the perimeter gate. Along the left side pathway of the facility is a shed. The shed door was observed ajar. Inside the shed were wheelchairs, walkers, unidentifiable medical equipment, and two, (2) bottles of chemicals/toxins. LPA walked to the right exterior pathway where another shed is located. The door to this shed was open. Inside the shed were large numbers of yard tools, power tools, chemicals and sharp objects. Leaned up against the shed were additional yard tools. LPA observed 2 parked vehicles in the backyard. A blue colored sedan along with a white pick up truck. The 2 vehicles obstruct the evacuation route of the facility. Residents in care often utilize walkers and wheelchairs. The two vehicles obstruct the pathway; preventing residents from getting wheelchairs or walkers through the walkway. LPA discussed observations and concerns with Administrator Ahmad Abdallatef, who coordinated with staff to make the corrections during the visit. Administrator rolled up the water hose, secured all of the yard tools moving them to the sheds. The sheds were then secured. The two vehicles were also removed from the backyard to unobstruct the pathway out of the facility. At approximately 1:50pm LPA requested the staffing schedule and the food menus as they were not posted. Administrator reported that the facility food menu and staffing schedule would need to be created and submitted to LPA at a later time/date. Based on observations and record reviews, a deficiencies will be cited to address the above-mentioned concerns. Please see attached LIC809-D. An exit interview was conducted, this report was reviewed, discussed, and then provided to the facility Representative.