Senior Care Records.

Facility Evaluation Report

Nick's Maple Home LLC, Fontana03/24/2022Licence 361800144

Capacity22
Census22
Date signed03/24/2022 04:21:31 PM
The inspector’s account

Licensing Program Analyst (LPA) Melody Brown arrived at the facility 03/24/2022 at 02:30 PM unannounced in order to complete the facility's Annual Inspection. LPA Brown met with Administrator Ahmad Abdallatef and advised of the purpose of the visit, and that the Annual Inspection will be limited to Infection Control only. Below is a summary of what was observed:

Infection Control: LPA Brown went over COVID-19 best practices for infection control and prevention with Administrator Ahmad Abdallatef and Administrator Ahmad Abdallatef reported that Mitigation Plan was submitted 10/01/2021. LPA Brown observed the facility having Covid-19 signages throughout the facility for proper hand washing procedure and social distancing. LPA Brown toured the facility and observed that client bathrooms have paper towels and hand soap. LPA Brown requested to inspect the facility's Personal Protective Equipment (PPE) supply. LPA Brown observed the facility to have a sufficient supply of sanitizer, gloves, masks, isolation gowns but no face shields/goggles. LPA Brown will be issuing a Technical Assistance Advisory Note instead of a deficiency due it being difficult to access face shields at numerous points during the COVID-19 pandemic. LPA Brown advised the facility to look online for items missing from their PPE supply kit, as CCL and Inland Regional Center may not have these items to supply them with.

LPA Brown went over the various recommended training for facility staff with Administrator Ahmad Abdallatef in relation to COVID-19 and Administrator Ahmad Abdallatef reported that all staff were trained on various aspects of infection control, recognition of symptoms of COVID-19, and donning/doffing of PPE.

LPA Brown inquired as to if staff have been fit tested for N95 masks, and Administrator Ahmed Ahmad Abdallatef informed LPA Brown that at this time staff have not been fit tested. LPA Brown will be issuing a Technical Assistance Advisory Note during today's inspection for staff not being fit tested for N95 masks.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction