360900521-3-8-2021-18-AS-RLAY-BYZUM4-20210311144142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900521
Report Date: 03/08/2021
Date Signed: 03/08/2021 02:21:39 PM

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
10/27/2020 and conducted by Evaluator Tricia Danielson

COMPLAINT CONTROL NUMBER: 18-AS-20201027121756

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: 74	DATE:	03/08/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Keely Miller, Administrator		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Facility trees in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tricia Danielson contacted the facility via telephone to conclude a complaint investigation into the allegation noted above. LPA met with Administrator (AD) Keely Miller.
The investigation revealed the facility removed a dead tree and LPA observed the remnants of it where it previously stood. There were no other trees which required trimming and/or removal observed on the property. LPA was also unable to find any evidence that the facility did not follow their neighborhood complaint policy. The issue has been resolved between both parties. The above allegation is found to be UNSUBSTANTIATED. 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 with AD and a copy of this report was provided via email and an electronic email read receipt confirms receipt of the documents. AD has agreed to sign the report and send a copy back to LPA.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Reyna Lacey	TELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia Danielson	TELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2021

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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