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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 01/21/2021
Date Signed: 01/21/2021 03:31:15 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
01/12/2021 and conducted by Evaluator Stephanie Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210112164856
FACILITY NAME:BRASWELL'S CHATEAU VILLAFACILITY NUMBER:
360902129
ADMINISTRATOR:JAMES BRASWELLFACILITY TYPE:
740
ADDRESS:620 E. HIGHLAND AVENUETELEPHONE:
(909) 793-0433
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:156CENSUS: 89DATE:
01/21/2021
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:James BraswellTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has pests
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Stephanie Williams contacted the facility to initiate a complaint investigation into the above allegation via telephone due to the COVID-19 pandemic. LPA identified herself and discussed the purpose of the call with Licensee, James Braswell. The investigation consisted of interviews with staff/residents and records review.

In regards to allegation #1, LPA interviewed Staff #1 (S1) who confirmed that at the end of December 2020, it was reported that there were sightings of rats in the facility. S1 stated that within 24 hours, an extermination company was called out to address the issue. S1 stated that the extermination company has been working continuously with the facility to eliminate the rats. LPA reviewed documentation from S1 which showed that the extermination company has visited the facility at least three times in the past and has been addressing the situation.

This agency has investigated the complaint alleging that the facility has pests. We have found that the
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie WilliamsTELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 18-AS-20210112164856
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 CHATEAU VILLA
FACILITY NUMBER: 360902129
VISIT DATE: 01/21/2021
NARRATIVE
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complaint was UNFOUNDED, meaning that the allegation was false, could not have happened, and/or is without reasonable basis. We have there dismissed the complaint.

An exit interview was conducted where this report was discussed and a copy of this report was sent to Braswell via email.

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Stephanie WilliamsTELEPHONE: (951) 248-0317
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2