360900521-4-14-2021-18-AS-RLAY-C25U27-20210416151129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360900521
Report Date: 10/15/2020
Date Signed: 04/14/2021 02:31:35 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
10/07/2019 and conducted by Evaluator Jennifer Semin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20191007110153

FACILITY NAME:	BRASWELL'S MEDITERRANEAN GARDENS		FACILITY NUMBER:	360900521
ADMINISTRATOR:	VIRGINIA BAUER		FACILITY TYPE:	740
ADDRESS:	12295 4TH STREET		TELEPHONE:	(909) 797-1131
CITY:	YUCAIPA	STATE: CA	ZIP CODE:	92399
CAPACITY:	130	CENSUS: 72	DATE:	10/15/2020
		UNANNOUNCED	TIME BEGAN:	03:44 PM
MET WITH:	Christel Bunney		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Resident is not receiving their medication deliveries in a timely manner
Facility staff made inappropriate comment towards resident in care
Facility staff is ignoring resident's calls for assistance

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jennifer Semin contacted the facility via telephone to deliver the final complaint investigation report. LPA identified herself and discussed the purpose of the call and the elements of the allegations with Front Office Receprionist, Christel Bunney. The investigation consisted of interviews with relevant parties.
The first allegation indicates the resident is not receiving their medication deliveries in a timely manner. Staff interviews revealed medication deliveries are given to the residents within an hour of their delivery. Staff indicated Resident 1 (R1) requested staff to hold their medication deliveries in R1’s absence. R1 would then pick them up at the front desk upon their return. Interviews with R1 revealed they did request that staff not deliver medications to R1’s room when they were not present and to hold them at the front desk. However, R1 stated upon their return, R1 requested staff deliver their medications within the hour of their return. Interviews further revealed the medications were then held by staff. Conflicting information was provided as to how long the medications were held, some say for over an hour and a half and others say the medications were not delivered until later that evening or until the next day. Interviews with other residents revealed, residents receive their deliveries in a timely manner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Jennifer Semin	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021

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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Control Number 18-AS-20191007110153

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
RIVERSIDE, CA 92507

FACILITY NAME: BRASWELL'S MEDITERRANEAN GARDENS	FACILITY NUMBER: 360900521
	VISIT DATE: 10/15/2020

NARRATIVE

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The second allegation indicates facility staff made an inappropriate comment towards resident in care. Staff interviews revealed staff deny speaking to residents inappropriately. Interviews with other residents revealed they have not heard any staff speaking inappropriately to any residents in care nor have staff spoken inappropriately to them. Interviews with R1 revealed they feel staff make inappropriate comments, such as saying R1 “is too demanding”, that R1 “is not the only resident that lives here”, that if R1 “wants their meds they can come up here and get them". Investigation did not reveal further information to either refute or corroborate the allegation.

The third allegation indicates facility staff is ignoring resident's calls for assistance. Staff interviews revealed they have never nor have they ever observed other staff, ignoring residents calls for assistance. Interviews with residents revealed staff provide assistance when needed. R1 stated staff do not provide assistance to them when needed and their calls for help are ignored. Investigation did not reveal further information to either refute or corroborate the allegation.

Based upon interviews and information gathered, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED at this time.

An exit interview was conducted with Ms. Bunney via telephone and a copy of this report was provided via email. Report with facility representative signature was obtained.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Jennifer Semin	TELEPHONE: (951) 473-7024
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021

LIC9099 (FAS) - (06/04)

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