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Inspection visit

Follow-up on corrections

NICK'S MAPLE HOME IIILicense 3618810352 citations on this visit
2 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Nick's Maple Home III to conduct an unannounced complaint visit for 56-AS-20230426163659. During visit, LPA observed deficiencies not related to the complaint allegations. At approximately 2:17pm, upon arrival to the facility, LPA observed an individual inside the facility's attached garage. LPA introduced self and stated purpose of the visit. The individual identified themselves as Amir Mangaoang. LPA was informed that Amir works at the facility as a handy man. During, the visit, LPA completed a walkthrough of the facility and completed a record review. LPA observed Amir Mangoaoang did not have a fingerprint clearance. This poses an immediate health and safety risk to residents in care. LPA also observed a window ajar on the second floor of the facility. The window was observed did not have a screen on it. Staff informed LPA, the room belongs to a resident in care. The screen was removed by a resident in care during a behavioral episode. This poses an immediate health and safety risk to residents in care. At approximately, 2:25pm LPA walked through the facility's backyard and observed a broken window on the facility's second floor. The glass of the window has several was cracked in serval places. Each crack in the window leads to a small whole in the center. Based on observations and interviews, two (2) deficiencies are being issues to address the above concerns. A Civil Penalty was assessed on 5/1/2023. Refer to LIC809-D for deficiencies cited. A copy of this report along with appeal rights are being reviewed with and provided to the facility representative. ** A Civil Penalty assessment accompanies the deficiency.

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 other inspection of NICK'S MAPLE HOME III on May 1, 2023. 2 citations were issued: 1 Type A (serious) and 1 Type B.

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

Yes, 2 citations were issued (1 Type A, 1 Type B). The first citation was for: "800918 Criminal Record Clearence(e) All individuals subject to a criminal record review..."(1) Obtain a California clear..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

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.