331881066-3-6-2026-18-AS-RORN-DRZQJW-20260309121325

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881066
Report Date: 03/06/2026
Date Signed: 03/06/2026 11:47:02 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
08/08/2023 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 18-AS-20230808161233

FACILITY NAME:	REM CALIFORNIA, LLC - SKYLAND		FACILITY NUMBER:	331881066
ADMINISTRATOR:	FLORENCE, TAMARA		FACILITY TYPE:	735
ADDRESS:	24795 SKYLAND DR		TELEPHONE:	(951) 601-3444
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92557
CAPACITY:	4	CENSUS: 4	DATE:	03/06/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	JACQUELINE ARIAS		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility staff yells at clients.
Facility failed to report incident.

INVESTIGATION FINDINGS:

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On March 06, 2026, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced complaint visit. LPA met with staff Brandyn Hamilton and explained the purpose of the visit. Later, LPA was joined by the Administrator (A1) Jacqueline Arias.

The investigation consisted of the following: On March 06, 2026, LPA Richard reviewed and obtained the Client Roster (dated 03/05/26) and the Staff Roster (dated 08/3/25). LPA also reviewed and obtained all documents relating to R1’s Face Sheet, Admission Agreement, IPP, and Physician Report. LPA also obtained a copy of the Report of Suspected Dependent Adult/Elder Abuse. (SOC341) dated July 18, 2023, Inland Regional Center Unusual Incident Report (dated July 17, 2023) (SIR), (CCLD), and the Facility investigation of the incident and the conclusion of termination notification of the Staff (dated July 26, 2023). At the same time, LPA interviewed the Administrator (A1), four staff members (S1-S4), and two clients (C1-C2).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

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 3

Control Number 18-AS-20230808161233

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: REM CALIFORNIA, LLC - SKYLAND	FACILITY NUMBER: 331881066
	VISIT DATE: 03/06/2026

NARRATIVE

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The Allegation #1: Facility staff yelling at clients.

The complaint alleged that a staff member was yelling at a client. On March 6, 2026, the LPA interviewed the Administrator (A1), who denied ever noticing staff yelling at a client since A1 became an Administrator. A1 believed this incident happened before A1 became an Administrator. A1 also stated that, once a month, the facility reminds staff of clients' rights and the importance of treating them with respect and dignity. During the same visit, the LPA interviewed four staff members (S1-S4), all of whom denied the allegation and stated that this is their home and they need to treat clients with respect, without yelling or verbal abuse. Additionally, the LPA interviewed two clients (C1-C2), both of whom denied being yelled at by staff; C1 could not recall any staff yelling at them. Records reviewed on March 6, 2026, indicated the facility self-reported the incident to SOC341. The records also showed that the facility investigated the incident on July 16, 2023. After the investigation concluded, the facility terminated the staff member for violating company policy and engaging in unprofessional behavior toward a client.

Although the allegation may have occurred or is valid, there is not a preponderance of evidence to confirm whether the alleged violation did or did not happen, so the allegation is unsubstantiated.

Report Continued on LIC9099C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20230808161233

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: REM CALIFORNIA, LLC - SKYLAND	FACILITY NUMBER: 331881066
	VISIT DATE: 03/06/2026

NARRATIVE

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Allegation #2: The facility failed to report the incident.

The complaint alleged that the facility failed to report the incident to Community Care Licensing (CCL). On March 6, 2026, the LPA interviewed the Administrator (A1), who denied the allegation and stated that the facility always reports any incidents, regardless of severity. At the same time, the LPA interviewed four staff members (S1-S4), all of whom denied the allegation and stated that they are mandated reporters; they first report the incident to the Administrator (A1) and write an unusual incident report to all appropriate parties. On March 06, 2026, LPA records reviewed showed that the facility reported the incident to the Inland Regional Center on July 17, 2023, to the Responsible Party on July 17, 2023, and to the Community Care Licensing Department (CCLD) on July 18, 2023.

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, therefore the allegation is unsubstantiated.

No deficiencies were cited.

An exit interview was conducted. A copy of the report was provided to the Administrator Jacqueline Arias.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC9099 (FAS) - (06/04)

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