Follow-up on corrections·November 15, 2023

Licensing Program Analyst, Amber Coleman, (LPA) arrived at Nick’s Maple Home II to conduct an unannounced complaint visit for #56-AS-20231108143629 During visit, LPA observed deficiencies not related to the complaint allegations. Staff informed LPA that Resident #1, (R1) was transported to the hospital on 10/30/23. LPA inquired the status of the incident reports. LPA informed that they would be sent to Community Care Licensing. On 11/9/23, LPA researched Community Care Licensing's Duty Logs to locate the incident report with no success. LPA contacted Administrator, Najeh Hamed to request the Incident Report. Incident report was emailed to LPA dating the occurring incident on 11/1/2023. There is no time stamp on the incident reports indicating the reports were not submitted to the Community Care Licensing Office within the Reporting Requirement Regulations. Based on observations and interviews, a deficiency will be cited per Title 22, California Code of Regulations to address the reporting requirements. An exit interview was conducted. This report was reviewed and discussed, then provided to Administrator.