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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700722
Report Date: 01/30/2025
Date Signed: 01/30/2025 03:59:39 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2025 and conducted by Evaluator Victoria Brown
COMPLAINT CONTROL NUMBER: 27-AS-20250129113614
FACILITY NAME:WELLQUEST OF ELK GROVEFACILITY NUMBER:
342700722
ADMINISTRATOR:CUEVAS, ELANAFACILITY TYPE:
740
ADDRESS:8871 E STOCKTON BLVDTELEPHONE:
(916) 689-1000
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:170CENSUS: 114DATE:
01/30/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elana CuevasTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Residents missed medications
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Victoria Brown arrived unannounced, conducted a complaint investigation on 1/30/25 at 1:30p. LPA met with Elena Cuevas, Executive Director and stated the purpose of the visit.
LPA requested staff work schedules to include any changes, LIC500 with staff contact, resident roster. LPA conducted interviews with Executive Director and Health and Wellness Director. LPA received a copy of the Incident report dated 11/22/24 which was self-reported to Communicuty Care Licensing (CCL) which was investigated on 12/3/2024. LPA received all requested documents for dates: 7/22/24, 7/29/24, 12/23/24, 12/24/24, 12/30/24. 1/21/25, 1/26/25, 1/27/25, 1/28/25. LPA reviewed QuickMar with S2 for the past 6 months. LPA did not observe that any residents missed medications.Based on interviews, documentation, and that there was no incidents that occurred, the preponderance of evidence has not been met. "The allegation is UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. This Department has therefore dismissed the complaint." Per California Code of Regulations, no deficiencies were observed or cited. Exit interview held, and a copy provided.
Unfounded
Estimated Days of Completion: 30
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Victoria Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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