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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881106
Report Date: 10/07/2025
Date Signed: 10/07/2025 01:14:56 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
08/13/2025 and conducted by Evaluator Valerie Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250813103203
FACILITY NAME:WELLQUEST OF MENIFEE LAKESFACILITY NUMBER:
331881106
ADMINISTRATOR:EADS, JONETTAFACILITY TYPE:
740
ADDRESS:29914 ANTELOPE RDTELEPHONE:
(951) 550-0500
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY:151CENSUS: 131DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Administrator, Jonetta EadsTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not dispense medication as prescribed
INVESTIGATION FINDINGS:
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On 10/7/2025, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering investigative findings into the allegation listed above. LPA Flores met with Administrator, Jonetta Eads, and explain to Jonetta the purpose of the visit. The investigation consisted of interviews and records review.

Information received alleged Staff #1 (S1) did not dispense Resident #1’s (R1) medication as prescribed. Interviews conducted with R1 and staff corroborated that at approximately 8AM on 08/04/2025, S1 arrived to R1’s room to assist with administering R1’s prescribed medication. Staff and R1 reported that all medications are dispensed into a small clear cup with the residents room number on the lid. Interview with S1 reported that all residents medications are dispensed in a clear cup prior to being passed out to all residents. S1 further reported that this tasks takes approximately 1 hour to complete and does not include the time the it takes when staff are conducting their medication rounds throughout the facility.
(Continue to LIC9099C...)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
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-20250813103203
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: WELLQUEST OF MENIFEE LAKES
FACILITY NUMBER: 331881106
VISIT DATE: 10/07/2025
NARRATIVE
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(Continuation from LIC9099)

S1 reported that S1 did not confirm if the clear cup matched R1’s room number and proceeded to give R1 the medication. S1 watched R1 swallowed the medication and walked out the residents room. According to S1, S1 did not notice the error until arriving to Resident #2’s (R2) unit and could not find R2’s medication. S1 called Staff #2 (S2) and informed S2 of the error. S1 was instructed to wait for S2’s guidance. Interview conducted with staff and R1 confirmed R1 was informed approximately 2 hours after the medication error. R1’s primary physician and responsible party were notified of the error. Interview with staff reported that R1’s Primary Care Physician instructed staff to monitor R1 for any side-effects. Interviews with staff and R1 confirmed R1 did not receive R1’s normal AM dosage of medication after the medication error as instructed by the Primary Care Physician. Interviews conducted with R1 and staff detailed that R1 was placed on alert charting where R1’s vitals were taken every hour. Records review conducted of the facility’s incident report confirmed the details of the incident. A records review conducted for R1’s physician report confirmed R1 requires assistance with medication management (i.e. assistance with administering medication, PRN medication, and storing medication). A records review conducted of R1’s Electronic Medication Administration Record (EMAR) confirmed that R1 did not receive their morning dosage of medication as instructed by the Primary Care Physician.

Based on interviews and records review, this allegation is deemed Substantiated. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. Pursuant to the California Code of Regulations, Title 22, Division 6, Health and Safety Code, a deficiency is cited on the attached LIC 9099-D.

An exit interview was conducted where a copy of this report was provided and discussed, along with a copy of LIC9099-D, and Appeal Rights were provided to Administrator, Jonetta Eads.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20250813103203
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: WELLQUEST OF MENIFEE LAKES
FACILITY NUMBER: 331881106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2025
Section Cited
CCR
87465(a)(4)
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87465 Incidental Medical and Dental
Incidental Medical and Dental Care(a)A plan for incidental medical and dental care shall be developed by each facility…(4)The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by:
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Administrator Jonetta Eads agreed to conduct an in-service training with all med-tech staff. The facility has now updated the labels on the medication dispensing cup to reflect name and room number of the receiving resident.
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Based on interview and record review, medication was not administered as prescribed by physician for (1) one out of (1) one as Resident 1 receive the wrong medication which poses a potential health, safety or personal rights risk to residents 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: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
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