Facility Evaluation Report

Licensing Program Analyst, , (LPA) LaVette Farlow arrived at the Nick's Maple Home III, unannounced to conduct an Annual Inspection. LPA was greeted by Caregiver, Malik Salem. LPA introduced self and stated purpose of the visit and was granted entry. Staff Malik contacted Administrator, Najeh Hamed to notify of LPA visit. LPA provided space to work, then a tour of the facility. Administrator Najeh arrived later and participate during the inspection.

Facility: The facility is two, (2) levels. It includes 5 bedrooms, 1 of the 5 bedrooms is for staff, a kitchen, two, (2) living room areas, dining room, laundry space, backyard and attached garage. The facility is approved for a capacity of 10. Eight (8) ambulatory and 2 non-ambulatory. There is a hospice waiver in place approval for 2. The current census is 8 resident in care. The temperature throughout the facility is a comfortable 73 degrees. The facility is equipped with operational smoke alarms, and carbon monoxide detectors. LPA observed two fully charged fire extinguishers. Each one was last inspected October 2024. The facility water was tested and the temperature ranged from 110.4, 117.3, and 118.5, all within regulations. LPA observed the facility did not have a Infection Control Plan available to residents, staff and CCL for review, and the licensee had not conduct the annual review of the emergency disaster plan. Deficiencies cited.

Resident Rooms - Each resident bedroom can accommodate any ambulatory resident. All resident bedrooms were adequately furnished with bed, storage space and lighting. LPA observed residents room were missing chairs and proper linen. Administrator corrected the linen and chairs issue prior to the end of the inspection. Technical advisory issued.

Bathrooms: All bathrooms contained working appliances and adequate hand hygiene and paper supplies. Hand rails and non-slip grip materials were observed near toilets and in showers/tubs. LPA observed cleaning supplies under the bathroom sink unsecured and accessible residents in care. Deficiency cited.

Kitchen - contained an adequate supply of dry goods, canned goods and non-perishable items for the amount of residents in care. Sharp objects, chemicals/cleaning supplies are maintained securely in a closet by the front door. Additional food items such as milk, bread, eggs, fresh fruits, condiments, cheese, cookies, ice cream, cereals and meats were located in the kitchen refrigerator and two deep freezers in the attached garage.