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Community Care Facilities Licensing
FACILITY INSPECTION REPORT
HEALTH & SAFETY
JKAS-CMQP8U
FACILITY NAME
122nd Avenue Home		SERVICE TYPES
140 Community Living
FACILITY LICENSE #
1081369
FACILITY ADDRESS
22229 122nd Ave		FACILITY PHONE
(604) 467-8828
CITY
Maple Ridge		POSTAL CODE
V2X 3X8		MANAGER
Angaline Madhavan
INSPECTION DATE
January 03, 2023		ADDITIONAL INSP. DATE (multi-day)
January 04, 2023		ADDITIONAL INSP. DATE (multi-day)
TIME SPENT (HRS.)
4.5
ARRIVAL
10:45 AM		DEPARTURE
02:45 PM		ARRIVAL
11:45 AM		DEPARTURE
12:00 PM		ARRIVAL
DEPARTURE
INSPECTION TYPE
Routine		# OBSERVED IN CARE
4
Introduction

An unscheduled routine inspection was conducted to assess compliance with the Community Care and Assisted Living Act (C.C.A.L.A.), the Residential Care Regulation (R.C.R.), and the relevant Director of Licensing Standards of Practice (D.L.S.P.). Evidence for this report was based on the licensing officer's observations, review of the facility records, and information provided by the facility staff at the time of inspection.

The following areas were reviewed:

- Licensing
- Physical Facility
- Policies and Procedures
- Care and Supervision
- Hygiene and Communicable Disease Control
- Medication
- Nutrition and Food Services
- Program
- Records and Reporting

As part of this routine inspection a facility risk assessment tool is completed. The risk assessment includes contraventions identified during the routine inspection, and a 3 year historical review of the facility's compliance and operation.

Visit the CCFL website at https://www.fraserhealth.ca/residentialcare for:
-Additional resources and
-Links to the Legislation(CCALA & RCR)

Contraventions
Previous Inspection -
Current Inspection - Items reviewed comply with the Act, regulations & standards of practice except for those noted on supplementary pages.
Observed Violations
NUTRITION AND FOOD SERVICES: 37040 - RCR s.62(2)(b) - A licensee must ensure that each menu provides (b) for each day, at least 2 nutritious snacks, with each snack containing at least 2 food groups as described in Canada's Food Guide.
Observation: Noted during inspection, upon review of the 4 week menu the menu does not have 2 nutrtitious snacks, with each snack containing at least 2 food groups.(This is a repeat contravention)
Corrective Action(s): Ensure that each menu provides for each day, at least 2 nutritious snacks, with each snack containing at least 2 food groups.
Date to be Corrected: January 17, 2023
Comments

This Licensing Officer would like to thank the Staff for their assistance in completing this routine inspection.

The Licensing Officer did not have access to staff files during inspection and the staff checklists were provided by the covering manager.


Please provide a written response by January 17, 2023 indicating the corrective actions taken and/or time line and plan for compliance with legislative requirements.

Please contact your Licensing Officer if you have any questions or concerns regarding this inspection report.

(Please note: this inspection report was reviewed with the covering manager on January 4, 2022, written on site and signed , a copy was provided to the manager.)
Action Required by Licensee/ManagerAction Required by Licensing Staff
Take corrective action to bring facility into compliance, Provide a written response to LicensingNo action required
Due Date
Jan 17, 2023
Click here for FAQ About Inspections.
Click here for a description of each "Category" of violation displayed.