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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360900100
Report Date: 05/22/2026
Date Signed: 05/22/2026 02:48:47 PM

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
01/22/2025 and conducted by Evaluator Paola Guerrero
COMPLAINT CONTROL NUMBER: 56-AS-20250122090224
FACILITY NAME:BRASWELLS YUCAIPA LEISURE MANORFACILITY NUMBER:
360900100
ADMINISTRATOR:LINDA WOOFTERFACILITY TYPE:
740
ADDRESS:32195 AVENUE ETELEPHONE:
(909) 797-1314
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:61CENSUS: 53DATE:
05/22/2026
UNANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Linda Woofter TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Resident developed pressure injuries.
Staff left resident on floor for an extended period of time.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Linda Woofter and explained the purpose of the visit regarding the allegations stated above.

First allegation: Resident developed pressure injuries. Regarding the allegation stated above, LPA conducted interviews with Staff #1, Staff #2, and Staff #3, regarding the alleged allegation and Staff #1-3 informed LPA that Resident #1 was ambulatory and overall physical status was good. Staff #1-3 further informed LPA that Resident #1 did not have bowel or bladder impairment and resident was fully capable of handling their own toileting needs. In addition, Staff #1-3 further explained that while Resident #1 was at the facility no pressure injuries were witnessed or reported. In addition, Staff #1-3 also indicated that Resident #1 was not receiving wound treatment.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026
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 56-AS-20250122090224
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: BRASWELLS YUCAIPA LEISURE MANOR
FACILITY NUMBER: 360900100
VISIT DATE: 05/22/2026
NARRATIVE
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LPA conducted a record review pertaining to Resident #1 during the review of records LPA discovered that Resident #1 was ambulatory and did not have any skin conditions. In addition, during the review of records LPA observed no records or reports stating that Resident #1 sustained pressure injuries.
Second allegation: Staff left resident on floor for an extended period of time. Regarding the allegation stated above, LPA conducted an interview with Resident #2 regarding the alleged allegation and Resident #2 informed LPA of being a witness when Resident #1 was lying on the bed and fell to the floor. Resident #2 informed LPA that resident waited for a while and then informed staff that Resident #1 was on the floor. Resident #2 informed LPA that staff immediately responded to Resident #1 and contacted 911. Resident #2 could not confirm the time that Resident #1 was on the floor but indicated that it was daytime. LPA conducted interviews with Staff #1-3 and all denied the alleged allegation and indicated that on 1/18/2025 at approximately 1:20PM Resident#2 informed staff that Resident #1 was on the floor unresponsive. Furthermore, Staff #1-3 informed LPA that Fire Department was contacted and transported Resident #1 to local hospital to be treated. Staff #1-3 informed LPA that on 1/21/2025 it was confirmed that Resident #1 had suffered a stroke. Based on corroborating evidence LPA has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Linda Woofter.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026
LIC9099 (FAS) - (06/04)
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