TORONTO -- An Ontario long-term care home that has been in a COVID-19 outbreak since mid-November has received an order of compliance from York Region’s medical officer of health due in part to what he describes as “inadequate senior leadership” at the institution and insufficient knowledge of infection prevention and control (IPAC) processes.

The order was issued by Dr. Karim Kurji, on New Year’s Eve and requires Villa Leonardo Gambin, a long-term care home in Vaughan, Ont. operated by Sienna Senior Living, to “comply with all direction related to the COVID-19 outbreak.”

An outbreak was declared at Villa Leonardo Gambin on Nov. 20. According to data available Saturday, there are 35 confirmed cases among residents and 14 among staff. Four residents have died since the outbreak was declared.

In total, 13 people have died at the home after contracting COVID-19 since January 2020.

In the order, officials say the long-term care home has “inadequate senior leadership … at all times to ensure appropriate adherence to IPAC measures.” It also says there is inadequate or insufficient IPAC knowledge at the home and that they require assistance from multiple health agencies, including York Region Public Health, Mackenzie Health Hospital, Public Health Ontario and the Local Health Integration Network, in order to provide that expertise.

No further details were provided regarding the specific assistance being provided by these additional health-care institutions.

As of Dec. 31, the facility was ordered to not only comply with all direction related to the outbreak, but also to provide staff and residents with “equipment, supplies, services or associated tools required to monitor, respond and control the outbreak and any further potential outbreak of COVID-19.”

Villa Leonardo Gambin has also been ordered to ensure sufficient staffing in order to respond to the outbreak, “including the presence of senior leadership (supervisory staffing) on all units to re-enforce IPAC measures,” and to ensure staff and essential visitors are trained on point of care risk assessment and appropriate use of personal protective equipment.

“These practices must be monitored,” the order says. “When non-compliance is observed, education must be immediately provided, and on an ongoing basis, to ensure compliance with IPAC measures.”

The final order instructs the home to ensure “the release of health information to any person or entity shall comply with the Health Protection and Promotion Act and the Personal Health Information Protection Act, 2004 and all applicable privacy laws.”

Failure to comply to these orders could result in a $5,000 fine per day.

Andrew Iacobelli, chair of the board of directors at Villa Leonardo Gambin, said in a statement the home is taking a number of "concrete steps" to address the concerns laid out by York Region Public Health.

"In addition, Mackenzie Health and York Region Public Health are providing guidance around strengthening education and training around infection prevention and control," Iacobelli said.

"The residence has the supplies of personal protective equipment it needs and we have fully implemented isolation precautions for residents. This includes providing their care, meals and activities in their rooms to protect them from the virus."

As of Saturday, the province reported 188 ongoing outbreaks at long-term care homes across Ontario.