360900521-5-21-2026-56-AS-KCLS-DVMQ8B-20260703115624

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900521
Report Date: 05/21/2026
Date Signed: 05/21/2026 05:51:11 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
09/16/2024 and conducted by Evaluator Andrew Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240916124147

FACILITY NAME:	BRASWELL'S MEDITERRANEAN GARDENS		FACILITY NUMBER:	360900521
ADMINISTRATOR:	KEELY MILLER		FACILITY TYPE:	740
ADDRESS:	12295 4TH STREET		TELEPHONE:	(909) 797-1131
CITY:	YUCAIPA	STATE: CA	ZIP CODE:	92399
CAPACITY:	130	CENSUS: 79	DATE:	05/21/2026
		UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Administrator, Maria Cervantes		TIME COMPLETED:	05:55 PM

ALLEGATION(S):

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Staff do not follow physicians orders.
Staff left resident in soiled linens.
Staff are not trained properly for transfers resulting in staff dropping resident.
Due to lack of staff, residents are not fed timely.
Due to lack of staff, residents needs are not being met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Andrew Martinez made an unannounced visit to continue the complaint investigation and deliver findings for the above allegations. LPA met with Maria Cervantes, Administrator, who was informed of the purpose of the visit and allegations. Today's continuation of the investigation consisted of interviews of current staff and residents, LPA's observations, and records review. Resident #1 (R1) no longer resides at the facility as of September 18, 2024 and could not be interviewed.

The allegations indicate:

Staff do not follow physicians orders. – Based on staff interviews and observation of medical records, staff acted in accordance with physician orders as reflected in the updated medical records provided to the facility. Based on the evidence, the allegation is UNSUBSTANTIATED.

***Continued on LIC 9099-C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Andrew Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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-20240916124147

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: BRASWELL'S MEDITERRANEAN GARDENS	FACILITY NUMBER: 360900521
	VISIT DATE: 05/21/2026

NARRATIVE

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Staff left resident in soiled linen. - Based on staff and resident interviews conducted, the information obtained did not yield sufficient evidence to substantiate the allegation under the preponderance of evidence standard. Based on lack of evidence, the allegation is UNSUBSTANTIATED.

Staff are not trained properly for transfers resulting in staff dropping resident. - Based on staff interviews and review of facility's unusual or special incident reports (UIR/SIR) submitted to Licensing, no incidents involving a resident falling were identified as them being dropped resulting from inadequate staff training. Based on resident interviews, no resident reported they have been dropped or sustained any falls related to inadequate staff training. Based on the evidence, the allegation is UNSUBSTANTIATED.

Due to lack of staff, residents are not fed timely. - Based on today's interviews with staff and residents, interviews confirmed that meals are provided within a reasonable timeframe during routine mealtimes, including breakfast at approximately 8:00 a.m., lunch at 12:00 p.m., and dinner at 5:00 p.m. Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED.

Due to lack of staff, residents needs are not being met. - Based on a review of the facility’s LIC 500 reports and staffing schedules for August and September 2024, as well as today, records indicate the facility employed and currently employs an adequate amount of staff to meet the needs of residents. Based on interviews conducted, staff and residents reported that resident's care needs are ultimately met and fulfilled, despite occasional inconsistencies in staff's response times. Based on the evidence, the allegation is UNSUBSTANTIATED.

During the complaint investigation, LPA could not find evidence to corroborate the allegations mentioned above. 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 did or did not occur, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report (LIC 9099 and LIC 9099-C) was discussed, and a copy was provided to Administrator, Maria Cervantes.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Andrew Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

LIC9099 (FAS) - (06/04)

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