360902129-10-22-2021-18-AS-JESL-CQD6CE-20230328204125

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 09/21/2021
Date Signed: 10/22/2021 11:30:47 AM

Unfounded

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
07/30/2021 and conducted by Evaluator Elecia Weathersby

COMPLAINT CONTROL NUMBER: 18-AS-20210730090627

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: 86	DATE:	09/21/2021
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Licensee, Jim Braswell		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Residents are not offered water.
Residents are not offered food.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst's (LPA) Elecia Weathersby made an unannounced visit to the facility for the purpose of investigating complaints regarding the above allegations. LPA met with facility Licensee, Jim Braswell and explained the purpose of the visit. Below is a summary of the findings of the investigation:

Allegation #7: Residents are not offered water.
LPA was unable to verify by sight or interviews, that resident's are not offered water. LPA witnessed lunch being served to residents during facility visit an accessible water station located in the dining area.

Allegation #8: Residents are not offered food.
LPA was unable to verify by sight or interviews, that resident's are not offered food. LPA witnessed lunch being served to residents during facility visit and lunch delivery, to one of the interviewed resident's room.

Based upon interviews and information gathered, the allegation is UNFOUNDED, meaning that the allegation is false, could not have happened, or is without a reasonable basis.

An exit interview was conducted and a copy of this report and LIC811 was provided to Licensee, Jim Braswell.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Elecia Weathersby	TELEPHONE: (951) 255-9516
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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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