331800081-11-29-2022-18-AS-TDAN-D4U676-20240430203300

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800081
Report Date: 11/29/2022
Date Signed: 11/29/2022 10:02:23 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
08/31/2021 and conducted by Evaluator Crystal Colvin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210831165539

FACILITY NAME:	BUSMAN RESIDENTIAL CARE LLC		FACILITY NUMBER:	331800081
ADMINISTRATOR:	READE, JOHN		FACILITY TYPE:	740
ADDRESS:	27892 BUSMAN ROAD		TELEPHONE:	(951) 888-9512
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 5	DATE:	11/29/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	John Reade - Administrator		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Facility staff violate residents personal rights

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 "Facility staff violate residents personal rights": Department staff previously interviewed staff related to the allegation. 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. 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (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)

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