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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 312700251
Report Date: 10/03/2022
Date Signed: 10/03/2022 01:57:36 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2022 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 25-AS-20220429145458
FACILITY NAME:BROOKFIELD HOME CAREFACILITY NUMBER:
312700251
ADMINISTRATOR:MCGILL, RAMONAFACILITY TYPE:
740
ADDRESS:5342 BROOKFIELD CIRCLETELEPHONE:
(916) 415-1012
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:6CENSUS: 3DATE:
10/03/2022
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Ramona McGillTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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9
Staff was told to sleep in a bathroom at the facility.
Facility is dirty.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 10/03/22 to deliver findings of the complaint investigation for above allegations. LPA met with administrator Ramona McGill and explained the purpose of the visit. Prior to the visit , LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA wore the following Personal Protective Equipment (PPE) during today's visit-surgical mask. LPA was screened by facility staff upon entry.

The department conducted records review ,facility observations and interviews to investigate the complaint.



**Report continued on LIC9099-C**
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2022 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 25-AS-20220429145458

FACILITY NAME:BROOKFIELD HOME CAREFACILITY NUMBER:
312700251
ADMINISTRATOR:MCGILL, RAMONAFACILITY TYPE:
740
ADDRESS:5342 BROOKFIELD CIRCLETELEPHONE:
(916) 415-1012
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:6CENSUS: 3DATE:
10/03/2022
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Ramona McGillTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Residents are left alone without staff at night.
Staff are not assisting residents with managed incontinence.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 10/03/22 to deliver findings of the complaint investigation for above allegations. LPA met with administrator Ramona McGill and explained the purpose of the visit. Prior to the visit , LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA wore the following Personal Protective Equipment (PPE) during today's visit-surgical mask. LPA was screened by facility staff upon entry.

The department conducted records review ,facility observations and interviews to investigate the complaint.



**Report continued on LIC9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 25-AS-20220429145458
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: BROOKFIELD HOME CARE
FACILITY NUMBER: 312700251
VISIT DATE: 10/03/2022
NARRATIVE
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**report continued from 9099(A)-----

Allegation- Residents are left alone without staff at night. -UNSUBSTANIATED.

The department conducted interviews and records review to investigate above allegation. Department revealed from facility record review from April 2022 through September 2022 that facility have staff working night shifts. Facility residents stated during interviews that residents are not left alone at night and facility has awake night staff to provide care and supervision. Based on this information, department has concluded that this allegation is UNSUBSTANTIATED.

Allegation- Staff are not assisting residents with managed incontinence. UNSUBSTANTIATED.



The department conducted interviews, facility observation and record review to investigate above allegation. During interviews with facility staff and residents, it has been revealed that facility are providing care to residents according to resident’s needs and service plans. During residents’ and staff interviews, it has been concluded that facility has enough staff to meet the needs of the residents in care. During department visits, department observed that residents appeared to be well groomed and in good care, therefore, the above allegation is found to be UNSUBSTANTIATED.

Based on interviews conducted by the Department, facility observations and records review, the preponderance of evidence standards has not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

No citations were issued today. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.


SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 25-AS-20220429145458
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: BROOKFIELD HOME CARE
FACILITY NUMBER: 312700251
VISIT DATE: 10/03/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
**report continued from 9099-----

Allegation- Staff was told to sleep in a bathroom at the facility. UNFOUNDED.

The department conducted interviews, facility observations and records review to investigate above allegation. Based on interviews with residents and facility staff, department learned that staff are not sleeping in the bathroom at the facility. During facility observations, department has observed no evidence that facility staff were sleeping at any of facility bathrooms. Based on this information, department has concluded that this allegation is UNFOUNDED. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.

Allegation- Facility is dirty. UNFOUNDED,

The department conducted interviews and facility observations to investigate this allegation. During departmental visits, department did not observe any unsanitary practices at the time of the facility inspection. In addition, interviews with residents and staff indicated that facility staff clean the facility daily including disinfecting. The department has investigated the complaint alleging (Facility is dirty). We have found the complaint was UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.



Based on information above, department concluded that all these allegations are UNFOUNDED, A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.

No citations were issued today. Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.



SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4