360902129-3-21-2024-56-AS-KCLS-D3SN7K-20240328101251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 03/21/2024
Date Signed: 03/21/2024 11:14:12 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
03/14/2024 and conducted by Evaluator Magda Malcore

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240314112044

FACILITY NAME:	BRASWELL'S CHATEAU VILLA		FACILITY NUMBER:	360902129
ADMINISTRATOR:	MELANIE NIEZ		FACILITY TYPE:	740
ADDRESS:	620 E. HIGHLAND AVENUE		TELEPHONE:	(909) 793-0433
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY:	156; 156	CENSUS: 112	DATE:	03/21/2024
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Melanie Niez - Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff did not provide filtered water to drink to a resident per Admission Agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA met with Melanie Niez, Administrator, and discussed the purpose of the visit.
Regarding the allegation, staff did not provided filtered water to drink to a resident per Admission Agreement. LPA review of resident #1 (R1's) admission's agreement reveals no documentation of an agreement to provide filtered water.

Based on interviews and record review, the above allegation is Unfounded. An Unfounded finding means, the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted where this report was discussed and a copy of this report was provided to the Administrator at the conclusion of the visit.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Magda Malcore	TELEPHONE: 951-248-0316
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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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