360900521-3-15-2024-56-AS-EMAN-D4GMFP-20240419093441

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900521
Report Date: 03/15/2024
Date Signed: 03/15/2024 11:38:18 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
03/11/2024 and conducted by Evaluator Ryan Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240311093246

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:	03/15/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Keely Miller- Administrator		TIME COMPLETED:	11:50 AM

ALLEGATION(S):

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Staff withheld residents debit card.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to investigate and deliver findings for the allegation listed above. LPA stated the purpose of the visit, was granted entry, and met with Administrator Keely Miller. The investigation consisted of resident interviews, staff interviews, and document review.

For allegation, Staff withheld residents debit card. It was alleged that the facility had Resident R1’s debit card in their possession.

Interviews with the staff revealed that Resident R1 is self-responsible and does not have a conservator or power of attorney. It was revealed that R1 requested the facility to secure R1’s debit card in a lock box in the front office. R1 signed a document on upon admission on 2/22/2024 allowing the facility to safeguard R1’s debit card. The facility provided R1 full access to obtain the debit card when requested. The staff denied withholding the debit card from R1.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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-20240311093246

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BRASWELL'S MEDITERRANEAN GARDENS	FACILITY NUMBER: 360900521
	VISIT DATE: 03/15/2024

NARRATIVE

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The staff denied knowing the PIN number to the debit card. The staff denied that purchases were made by the staff using the debit card. On 3/4/2024, the staff asked R1 if they wanted to open a trust account to safeguard funds but R1 denied and continued to return the debit card to the front office. During today’s visit, the Administrator informed LPA that they would contact R1’s family to inquire about conservatorship over finances. If the family does not want to be involved with R1’s finances, the Administrator will contact the County of San Bernardino to inquire if a county conservatorship over finances would fit R1’s financial needs.

Interview with R1 revealed that upon admission to the facility R1 asked the facility to safeguard their debit card. R1 willingly signed a document allowing the facility to secure R1’s debit card in the front office. R1 did not have concerns about purchases made with their debit card. R1 denied that their debit card was withheld from R1. R1 informed LPA that they changed their mind, would like the debit card returned, and wants to discontinue the facility from securing the debit card.

Interviews with additional residents at the facility did not reveal information that other residents had issues with the facility safeguarding or handling their finances.

A document review of R1’s record revealed that R1 is self-responsible, does not have a conservator, and does not have a power of attorney. R1’s admission agreement was signed and dated on 2/22/2024. On 2/22/2024, R1 signed a document allowing the facility to safeguard their debit card. A document review of R1’s record revealed notes for outings on 2/22/2024, 3/4/2024, and 3/11/2024 where R1 used their debit card to make purchases.

During today’s visit, R1’s debit card was returned to R1 and is no longer in possession of the facility.

Overall, there was not enough evidence to collaborate the allegation listed above. Based on evidence obtained during the investigation, the allegation listed above is deemed 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 did or did not occur.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.
An exit interview was conducted, and this report (LIC9099) was discussed and provided Administrator Keely Smith, along with a copy of the appeal rights.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-8222
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 836-3180
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

LIC9099 (FAS) - (06/04)

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