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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360902129
Report Date: 05/11/2023
Date Signed: 05/15/2023 01:59:48 PM


Document Has Been Signed on 05/15/2023 01:59 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA



FACILITY NAME:BRASWELL'S CHATEAU VILLAFACILITY NUMBER:
360902129
ADMINISTRATOR:MELANIE NIEZFACILITY TYPE:
740
ADDRESS:620 E. HIGHLAND AVENUETELEPHONE:
(909) 793-0433
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:156CENSUS: 91DATE:
05/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Melanie Niez, Administrator TIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to deliver amended complaint findings for complaint control number 18-AS-20210726134618, that were given on July 28, 2021.

LPA met with Melanie Niez, and explained the purpose of the visit.

There were no heath and safety concerns were observed at the time of LPA's visit.

An exit interview was conducted, and a copy of this report was reviewed and provided to Melanie Niez, Administrator.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina GeorgeTELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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