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Inspection visit

complaint

NICK'S MAPLE HOME IIILicense 361881035
Clean visit · 0 citations

Inspector’s narrative

What the inspector wrote

LPA made multiple attempts to meet and speak with R1. Staff confirmed that R1 relocated to a location that could provide a higher level of care. Reviews of records revealed that the facility provides care to residents that may suffer from memory impairments, history of mental illness and require assistance with medication management. LPA unable to obtain a copy of the Police Report. Reporting Party and Administrator a history of R1 making similar claims, but no evidence could be observed or located. LPA observed staff present during visit completing tasks such as cleaning and laundry service. Another staff member, was observed returning to facility during visit. According to staff interviews, staff lives on facility grounds. According to resident interviews, staff lives on site. Staff provides assistance with medications, laundry, meal preparations and assistance with activities of daily living throughout the day and night. Based on information above, the allegation is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with Facility Representative and a copy of this report was provided.

Citations

2 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.

  • 80019(e)(1)Type A

    800918 Criminal Record Clearence(e) All individuals subject to a criminal record review..."(1) Obtain a California clearance or a criminal record exemption as required by the Department orThe requirement is not met as evidenced by: Based on observation, record reviews and interviews the licensee did not ensure all staff had a criminal records clearence to be employed at the facility which poses an immediate Health and Safety to risk to persons in care.

  • 87303(a)Type B

    87303 Maintenance and Operation(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors This requirement was not met as evidenced by:Based on observation, record reviews and interviews the licensee did not ensure facility was in good repair which poses an a potential Health and Safety to risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the May 1, 2023 inspection of NICK'S MAPLE HOME III?

This was a complaint inspection of NICK'S MAPLE HOME III on May 1, 2023. The inspection found no deficiencies and no citations were issued.

Were any citations issued to NICK'S MAPLE HOME III on May 1, 2023?

No citations were issued during this inspection. The facility was found to be in compliance with all applicable regulations.

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.