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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366425325
Report Date: 08/21/2025
Date Signed: 08/21/2025 10:40:33 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
11/07/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20241107120742
FACILITY NAME:CHANTILLY LACE MANORFACILITY NUMBER:
366425325
ADMINISTRATOR:TERESA BADDELEYFACILITY TYPE:
740
ADDRESS:7421 MINSTEAD AVETELEPHONE:
(760) 552-9980
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:6CENSUS: 6DATE:
08/21/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Teresa BaddeleyTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff forced a resident to take medication
Staff administered another resident's prescribed medication to a resident
Staff restrained a resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conclude and deliver the findings on the above allegations. LPA was granted entry into the facility and met with Administrator, Teresa Baddeley. The investigation consisted of record review and interviews with pertinent parties.

Regarding the allegation, staff forced a resident to take medication, interview with Resident #1 (R1) reveals that staff did not force them to take medication. Interviews with the Administrator and two (2) staff deny forcing any residents to take medications.

Regarding the allegation, staff administered another resident's prescribed medication to a resident, review of resident’s medication records reveals medications were given as prescribed. Interviews with the Administrator and two (2) staff deny administering another resident’s prescribed medication to another resident.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
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-20241107120742
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: CHANTILLY LACE MANOR
FACILITY NUMBER: 366425325
VISIT DATE: 08/21/2025
NARRATIVE
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Regarding the allegation, staff restrained a resident, it was alleged that staff physically restrained R1. Interview with (R1) reveals they were not restrained by staff. Interviews with the Administrator and two (2) staff deny restraining any residents.

Based on this department’s investigation, the allegations mentioned in this report are Unsubstantiated. An Unsubstantiated finding means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed, and a copy was provided with appeal rights to Administrator Baddeley at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2