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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336402685
Report Date: 11/22/2023
Date Signed: 11/22/2023 02:35:29 PM

Document Has Been Signed on 11/22/2023 02:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 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: 14DATE:
11/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Administrator, Kelly ColletTIME COMPLETED:
02:45 PM
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On 11/22/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct a required annual visit. LPA met with Administrator, Kelly Collet who was informed of the purpose of the visit.

LPA conducted a tour with Administrator Collet and observed that the facility is made up of five (5) classrooms, three (3) bathrooms, two (2) offices, a storage room, kitchen, and changing room. During LPA's visit, there was 14 clients and 10 direct care staff present. LPA observed clients in the classrooms as they prepared to go home for the day.

During today's visit, LPA observed the facility is clean and physical plant is in good repair. The facility has fire extinguishers charged and mounted throughout the facility. Carbon monoxide and smoke detectors were tested and found functional. The facility's last earthquake drill was held on 10/19/2023 and the last fire drill on 11/14/2023. LPA reviewed random staff files and found that staff had a criminal background clearance on file, were associated to the facility, and had current CPR/First Aid and CPI training. LPA also reviewed random client files and found that files had updated Individual Program Plans and Physican's Report along with signed admission agreements. The facility provides snacks for clients. LPA observed the kitchen area to be clean and snacks stored in a safe and healthful manner. Cleaning solutions are secured in locked storage rooms. The hot water temperatures in the bathrooms measured at 110-, 112-, and 113- degrees Fahrenheit. The thermostat was comfortably set to 72 degrees Fahrenheit. The facility does not dispense medications for any of their current clients. There are no bodies of water on the premises. Indoor passageways were free of obstruction.

Continued on LIC809-C.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 11/22/2023
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Continued from LIC809.

During today's visit, LPA did not observe any deficiencies. The facility was given a Technical Advisory to update their facility roster and remove any employees that are no longer working in the facility. A copy of this report was reviewed and provided to Administrator Collet.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2023
LIC809 (FAS) - (06/04)
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