360902129-9-20-2024-56-AS-EMAN-DC428M-20241218161035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 09/20/2024
Date Signed: 09/20/2024 11:51:54 AM

Unsubstantiated

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
06/25/2024 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240625091930

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: 116	DATE:	09/20/2024
		UNANNOUNCED	TIME BEGAN:	08:54 AM
MET WITH:	Melanie Niez		TIME COMPLETED:	11:55 AM

ALLEGATION(S):

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Staff are not administering resident's medications.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Mary Rico and Raquel Hernandez conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPAs met with Administrator Melanie Niez and explained the purpose of the visit. The investigation consisted of staff interviews, client interviews and facility tour.

For the allegation, Staff are not administering resident's medications.

LPA Rico and LPA Hernandez conducted six (6) staff interviews and seven (7) resident interviews.During staff interviews 6 out of the 6 staff stated that residents receive their medication. 6 out of the 6 staff also stated they have not witness other staff members refuse to provide residents medication.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary Rico	TELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

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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Control Number 56-AS-20240625091930

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BRASWELL'S CHATEAU VILLA	FACILITY NUMBER: 360902129
	VISIT DATE: 09/20/2024

NARRATIVE

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In addition, 7 out of the 7 residents stated they receive their medications. 7 out of the 7 residents also stated they have not been denied.

During medication audit, LPA Rico observed medications to be dispensed properly.

Based on the evidence found during the investigation, the one (1) allegation listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC9099) was discussed and provided to Administrator Melanie Niez.

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0337
LICENSING EVALUATOR NAME: Mary Rico	TELEPHONE: (951) 248-0293
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

LIC9099 (FAS) - (06/04)

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