336426731-12-9-2021-18-AS-KCLS-CPRNPC-20230309093804

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426731
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:28:50 PM

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
11/04/2020 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20201104114021

FACILITY NAME:	BRILLIANCE PLACE		FACILITY NUMBER:	336426731
ADMINISTRATOR:	MANALANSAN, SUZETTE		FACILITY TYPE:	735
ADDRESS:	1947 BRILLIANCE LANE		TELEPHONE:	(951) 294-0356
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92582
CAPACITY:	6	CENSUS: 4	DATE:	12/09/2021
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Riza Javier		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee failed to give back resident belongings in a timely manner.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conclude a complaint investigation regarding an allegation that Licensee failed to give back resident belongings in a timely manner. LPA met with Riza Javier. Interview with Licensee state that resident #1 (R1) in question, abruptly left facility leaving behind personal belongings. Arrangements were eventually made to retrieve those belongings by a third party. Interview with R1 states that the personal belongings were eventually received approximately 7 days later.

Based on the information obtained there is not enough evidence that Licensee failed to give back resident belongings in a timely manner. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. 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, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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