360900521-9-19-2024-56-AS-KCLS-DA3S7E-20241015133724

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900521
Report Date: 09/19/2024
Date Signed: 09/19/2024 02:59:04 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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/17/2024 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20240917092819

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: 84	DATE:	09/19/2024
		UNANNOUNCED	TIME BEGAN:	01:02 PM
MET WITH:	Kara Richardson Customer Liaison		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Licensee does not ensure the facility has running water
Licensee does not ensure the facility has working toilets
Licensee does not ensure facility is adequately staffed to meet resident's needs.
Licensee does not ensure facility is adequately staffed to meet resident's toileting needs.
Facility staff do not provide adequate food service to residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to initiate and deliver findings for the mentioned allegations. LPA met with Kara Richardson Customer Liaison who was informed of the purpose of the visit and allegations.

The investigation consisted of interviews with staff, residents, record review, and observations.
LPA toured the facility and seven (7) resident’s rooms and observed that all toilets in the rooms were operating/flushing and there was running hot water that measured between 105-110 degrees. LPA also observed the kitchen staff washing dishes with hot water.

Residents were interviewed and they stated they receive the help that they need but it comes slow sometime and additional staff would be helpful. The residents stated that the food service is good to them, and they don’t have any complaints. LPA observed residents in the dining area eating a balanced lunch baked chicken, mashed potatoes, green peas, fruit, water, and juice. There was also a menu avaliable for review.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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-20240917092819

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: BRASWELL'S MEDITERRANEAN GARDENS	FACILITY NUMBER: 360900521
	VISIT DATE: 09/19/2024

NARRATIVE

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Staff members were interviewed, and they stated additional staff is needed to meet the needs of the residents in care, but they work with who they have. LPA interviewed the licensee Mr. Braswell who stated he is aware additional staff is needed which is being addressed and interviews were currently being conducted and they have potential staff who have been cleared for employment and training is due to start in a week or two.

Based on interviews, observations and evidence gathered during the investigation, the above allegation is found to be Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted and discussed with Kara Richardson Customer Liaison and a copy of the report was provided at the conclusion of the visit with appeal rights.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC9099 (FAS) - (06/04)

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