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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336402685
Report Date: 03/13/2024
Date Signed: 03/13/2024 11:36:45 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
03/04/2024 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240304112202
FACILITY NAME:UNLIMITED QUEST INC EDGEMONTFACILITY NUMBER:
336402685
ADMINISTRATOR:JONES, REGINAFACILITY TYPE:
775
ADDRESS:23900 ALLESANDRO BLVD STE ATELEPHONE:
(951) 653-0054
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:45CENSUS: 46DATE:
03/13/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ethel Lynett Matthews - StaffTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff failed to assist client with toileting
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced in order to initiate an investigation of a complaint with the above allegation(s). LPA identified herself and discussed the purpose of the visit and the elements of the allegation(s) with staff Ethel Lynett Matthews. Below is a summary of the complaint investigation findings:

Regarding allegation "Staff failed to assist client with toileting": LPA Colvin conducted interviews with staff and client(s) and reviewed facility records. LPA Colvin noted that according to Client One's (C1's) Individual Program Plan (IPP) that C1 is able to toilet on their own, but due to their non-ambulatory status they may need some assistance from staff. Interviews additionally revealed that C1 is able to communicate with staff regarding their toileting needs. Interviews conducted by LPA Colvin do not support the allegation, as staff report that C1 was dry when they checked C1 prior to calling C1's home to have C1 picked up to address possible hygiene concerns (staff report C1 "smelled" but that it was not from a soiled diaper). C1 additionally denied soiling themselves while at the Day Program.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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 18-AS-20240304112202
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: UNLIMITED QUEST INC EDGEMONT
FACILITY NUMBER: 336402685
VISIT DATE: 03/13/2024
NARRATIVE
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Therefore, due to lack of evidence, the allegation of "Staff failed to assist client with toileting" is UNSUBSTANTIATED.

A finding of UNSUBSTANTIATED means 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 with staff Ethel Lynett Matthews and a copy of this report was provided.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2