360900100-6-2-2026-56-AS-KCLS-DWNPYC-20260805114343

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900100
Report Date: 06/02/2026
Date Signed: 06/02/2026 03:13:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 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
02/09/2026 and conducted by Evaluator Andrew Martinez

COMPLAINT CONTROL NUMBER: 56-AS-20260209213256

FACILITY NAME:	BRASWELLS YUCAIPA LEISURE MANOR		FACILITY NUMBER:	360900100
ADMINISTRATOR:	LINDA WOOFTER		FACILITY TYPE:	740
ADDRESS:	32195 AVENUE E		TELEPHONE:	(909) 797-1314
CITY:	YUCAIPA	STATE: CA	ZIP CODE:	92399
CAPACITY:	61	CENSUS: 54	DATE:	06/02/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Administrator Linda Woofter		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility retained resident who requires a higher level of care.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Andrew Martinez and Edith Conchas made an unannounced visit to the facility for the purpose of completing an investigation into the above complaint allegation. LPAs met with Administrator Linda Woofter and explained the reason for the visit. Today’s visit consisted of staff interviews and records review. R1 is no longer a resident of the facility and was unable to be interviewed.

For the allegation: Facility retained resident who requires a higher level of care. Based on LPA’s records review, records revealed R1 was admitted to the facility following the required evaluation of the resident's Medical Assessment for Residential Care Facilities for the Elderly (LIC 602A) and Preplacement Appraisal Information (LIC 603), which had indicated that the facility could appropriately address the resident's care needs. LPA observed R1’s post acute treatment center records that also did not reveal R1 required a higher level of care needed per the transfer/discharge reports. Based on interview conducted with the facility Administrator, the information documented in R1's LIC 602A and LIC 603, that were completed prior to R1s admission to the facility, they did not indicate a need for a higher level of care.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Andrew Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

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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Control Number 56-AS-20260209213256

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BRASWELLS YUCAIPA LEISURE MANOR	FACILITY NUMBER: 360900100
	VISIT DATE: 06/02/2026

NARRATIVE

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*** Continued from LIC 9099 ***

As a result, the facility determined that it could meet R1's care needs and admitted R1 for residency. Administrator reported that R1’s behavior had abruptly changed within days after the resident was admitted to facility. Records revealed R1 was admitted to the hospital on or around February 7, 2026, for psychiatric evaluation and never returned to the facility. Based on interviews and records review, this allegation is UNSUBSTANTIATED.

During the investigation, LPA did not find evidence to corroborate the allegations.

Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur.

An exit interview was conducted where this Complaint Investigation Report (LIC 9099, LIC 9099-C) was discussed and copy provided to Administrator Linda Woofter.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Andrew Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

LIC9099 (FAS) - (06/04)

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