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Inspection visit

complaint

NICK'S MAPLE HOME IIILicense 3618810351 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analysts (LPA) Anna Bueno and Licensee Najeh Hamed met at the San Bernardino Regional Office on this day. The Department investigation consisted of resident and staff interviews, resident records review, and observations of the physical plant. It is alleged that the Facility is operating over capacity. Nine of nine records were reviewed and 3 non-ambulatory residents were found. This facility is licensed for two non-ambulatory residents who may only occupy the first floor bedroom, and no Dementia care plan was submitted to and approved by the Department. This allegation is therefore substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. This poses a potential risk health and safety risk to residents in care. Refer to LIC809-D for deficiency cited. An exit interview was conducted where this report, LIC809-D, and appeal rights were discussed with and provided to Licensee

Citations

4 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.

  • 87204(b)Type B

    Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate non ambulatory residents. Residents whose condition becomes non ambulatory shall not remain in rooms restricted to ambulatory residents. This requirement was not met as evidenced by:Resident 1 is non-ambulatory is occupying bedroom #5. Fire clearance only allow the 1st floor bedroom to be occupied by non-ambulatory clients. This poses a potential health and safety risk to residents in care.

  • 87208(c)Type A

    (c) A licensee who accepts or retains residents diagnosed by a physician to have dementia shall include additional information in the plan of operation as specified in Section 87705(b). This requirement was not met as evidenced by:One of 9 resident records revealed that one resident is diagnosed with Dementia. This poses an immediate health and safety risk to residents in care.

  • 87506(b)Type B

    Resident Records(b) Each resident’s record shall contain at least the following information... (1) through (17)(F)This requirement was not met as evidenced by: Nine resident records were reviewed and all had missing documents such as, LIC 602 Physician's report, admission agreement, Pre-admission appraisal and/or re-appraisal.

  • 87204(a)Type A

    A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity. This requirement was not met as evidenced by:Three of 8 records were reviewed and found to be non-ambulatory. This poses an immediate health and safety risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the March 20, 2023 inspection of NICK'S MAPLE HOME III?

This was a complaint inspection of NICK'S MAPLE HOME III on March 20, 2023. 1 citation were issued: 1 Type A (serious).

Were any citations issued to NICK'S MAPLE HOME III on March 20, 2023?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate non ambulatory residents. R..."

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

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.