360902129-2-17-2023-18-AS-KCLS-CPCUEV-20230224143145

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 02/17/2023
Date Signed: 02/17/2023 01:00:20 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
08/07/2020 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 18-AS-20200807123801

FACILITY NAME:	BRASWELL'S CHATEAU VILLA		FACILITY NUMBER:	360902129
ADMINISTRATOR:	JAMES BRASWELL		FACILITY TYPE:	740
ADDRESS:	620 E. HIGHLAND AVENUE		TELEPHONE:	(909) 793-0433
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY:	156	CENSUS: 98	DATE:	02/17/2023
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Melanie Niez Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility staff did not serve food in a timely manner.
Facility staff is not meeting the resident's dietary needs.
Staff are not giving residents privacy.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Bernadette Allen made an unannounced visit to the facility for the purpose of delivering findings on a complaint conducted on 8/7/2020, by Licensing Program Analyst (LPA) Naisha Kendrix. LPA Kendrix contacted the facility via phone due to the COVID virus. LPA introduced herself and discussed the reason for the call and requested to conduct the call via Zoom.

Documentation states that resident 1 (R1) said the facility staff was provided with their doctor’s orders for special dietary needs. (R1) said that food is provided at another time if they are not ready to eat at the time food is scheduled to be served which is based on (R1's) request.
Resident 1 (R1) said that there is a lock on the door and staff members are not always allowed to come into the room while they are in the room.

LPA Naisha Kendrix conducted interviews with four (4) staff members who said (R1) has a history of locking the door and not allowing anyone entry into the room unless it is granted even when cleaning is needed which is done throughout the week.

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: 02/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

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-20200807123801

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 CHATEAU VILLA	FACILITY NUMBER: 360902129
	VISIT DATE: 02/17/2023

NARRATIVE

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Based on the interviews conducted by LPA Kendrix with the 4 staff members and (R1) statements the above allegations are unsubstantiated. A finding of unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted with Melanie Niez administrator and a copy the report with the appeal rights were provided at the conclusion of the visit.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Bernadette Allen	TELEPHONE: 951-897-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC9099 (FAS) - (06/04)

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