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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800081
Report Date: 11/29/2022
Date Signed: 11/29/2022 10:03:00 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/20/2021 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210820142432
FACILITY NAME:BUSMAN RESIDENTIAL CARE LLCFACILITY NUMBER:
331800081
ADMINISTRATOR:READE, JOHNFACILITY TYPE:
740
ADDRESS:27892 BUSMAN ROADTELEPHONE:
(951) 888-9512
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY:6CENSUS: 5DATE:
11/29/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:John Reade - AdministratorTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Staff member was physically abusive to resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of following up on the complaint with the above allegation. LPA Colvin met with Administrator John Reade and advised them of the purpose of today's visit. Below is a summary of the findings discussed:

Regarding allegation "Staff member was physically abusive to resident in care": Department staff previously interviewed staff and residents related to the allegation. All interviews conducted during initial investigation conceeded that there was no abuse ocurring at the facility. During today's inspection, LPA Colvin interviewed 4 of 5 current residents (one was asleep), as well as attempted to interview family of a deceased resident via telephone. LPA Colvin did not obtain any additional evidence today through interviews that would support the allegation, as the claim was either denied or the answers provided in interviews was inconsistent. Therefore, due to lack of evidence to support the claim, the allegation "Staff member was physically abusive to resident in care." is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 18-AS-20210820142432
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: BUSMAN RESIDENTIAL CARE LLC
FACILITY NUMBER: 331800081
VISIT DATE: 11/29/2022
NARRATIVE
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A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted with Administrator John Reade and a copy of this report was provided.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2