360902129-10-22-2021-18-AS-DMUN-C8JTY3-20211107140803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360902129
Report Date: 09/21/2021
Date Signed: 10/22/2021 12:04:10 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
08/12/2021 and conducted by Evaluator Elecia Weathersby

COMPLAINT CONTROL NUMBER: 18-AS-20210812151632

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:	03:28 PM

ALLEGATION(S):

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#1 Facility staff will not clean resident's room
#2 Facility is charging resident for a service he does not receive

INVESTIGATION FINDINGS:

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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 #1: Facility staff will not clean resident's room
LPA was unable to verify by sight, record review or interviews, that resident 1 (R1) or other residents, were not receiving cleaning services. R1 disclosed that R1 declines cleaning services and can clean without assistance from staff.

Allegation #2 Facility is charging resident for a service he does not receive
LPA verified by record review and interviews, that meal service is included in a resident's monthly fee and basic services amount. A residents monthly fee does not change should a resident decline meal services. RP admitted to this LPA that R1 declines all meals service provided by the facility.

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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