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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426745
Report Date: 06/19/2025
Date Signed: 06/25/2025 02:49:44 PM

Substantiated


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
07/31/2024 and conducted by Evaluator Valerie Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240731090425
FACILITY NAME:MATTHIAS HOMEFACILITY NUMBER:
336426745
ADMINISTRATOR:ADILENE QUINTANILLAFACILITY TYPE:
735
ADDRESS:13801 MOUNTAIN TOP DRIVETELEPHONE:
(760) 671-7421
CITY:DESERT HOT SPRINGSSTATE: CAZIP CODE:
92240
CAPACITY:6CENSUS: 5DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Administrator, Alexis ParkerTIME COMPLETED:
10:20 AM
ALLEGATION(S):
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Staff engaged in a physical altercation with a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering findings of the allegation listed above. LPA identified herself and discussed the purpose of the visit with staff, Briana Bryant. LPA was granted entry to the facility and a tour of the facility was conducted with Briana.
On 07/31/24, it was alleged staff engaged in a physical altercation with a client in care. Information obtained, revealed that one (1) client and three (3) staff were present at the facility during the time of the incident. All other clients were attending an outing outside the facility. Through interviews, it was alleged Staff #1 (S1) engaged in a verbal altercation with Client #1 (C1) over a movie C1 attended with Staff #2 (S2). The verbal altercation resulted in C1 experiencing a behavioral episode, causing C1 to strike S1 in the face. Interviews further revealed, S1 engaged in the altercation by striking C1 in the face and arm before Staff #3 (S3) called law enforcement. S2 attempted to mitigate the altercation between S1 and C1 while waiting for law-enforcement to arrive.
(Continue to LIC 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
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 3
Control Number 18-AS-20240731090425
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: MATTHIAS HOME
FACILITY NUMBER: 336426745
VISIT DATE: 06/19/2025
NARRATIVE
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 (Continuation from 9099)

Title 22, section 85102, restricts staff from using emergency intervention that involves any form of physical punishment or force towards clients in care. Furthermore, S1 did not comply with Title 22, Section 80072, by violating C1’s personal rights of being free from corporal or unusual punishment and/or infliction of pain.

The preponderance of evidence standard has been met. Therefore, the above allegations are substantiated. California Code of Regulations Title 22 is being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of this report LIC 9099D, and appeal rights were reviewed and provided to Administrator, Alexis Parker.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20240731090425
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: MATTHIAS HOME
FACILITY NUMBER: 336426745
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2025
Section Cited
CCR
85102(a)(5)
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(a) The following emergency interventions shall not be used on a client: (5) Pain, induced to control behavior or limit movement, including but not limited to arm twisting, finger bending, joint extensions and headlocks; This requirement was not met as evidence by:
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Administrator stated she will conduct a clients personal rights training with staff. Administrator stated she cannot conduct training by 6/20/2025 for all staff but can provide proof to LPA of training scheduled with Rhonda Chaw, Advocated Rights, by 6/20/2025 COB. Proof is to be sent via email.
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Based on interviews, Licensee did not ensure one (1) out of five (5) residents were free of emergency interventions that inflicted pain by evidence of Staff #1 striking Client #1 in the face and arm which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3