<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800835
Report Date: 10/25/2025
Date Signed: 10/25/2025 11:49:45 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251016104948
FACILITY NAME:HEGLIS CARE HOMEFACILITY NUMBER:
197800835
ADMINISTRATOR:JANE ANNE CUAFACILITY TYPE:
735
ADDRESS:3218 HEGLIS AVE.TELEPHONE:
(626) 280-0061
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:4CENSUS: 4DATE:
10/25/2025
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Mae Depra, DSP TIME COMPLETED:
11:56 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff member physically abused resident in care.
Staff member did not safeguard the personal possesion of resident in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
License Program Analyst (LPA) Alberto Lopez made subsequent visit on 10/25/2021 to deliver findings on above allegations.

The initial visit was on 10/20/2025. On 10/24/2025 LPA interviewed Administrator June Cua and one Witness W#1 via phone. LPA met with staff Mae Depra and discussed purpose of the visit.

The investigation consisted of LPA interviewing three (3) staff members S#1 – S#3, three (3) clients C#1 – C#3, one witness W#1, reviewing and obtaining staff and client rosters, C1 file documentation and incident report provided by facility.

(Continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2025
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 2
Control Number 28-AS-20251016104948
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: HEGLIS CARE HOME
FACILITY NUMBER: 197800835
VISIT DATE: 10/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(Continued from 9099)

The investigation revealed, regarding allegation: Staff member physically abused resident in care. It is alleged that staff member slapped and pushed client to the floor. LPA interviewed three (3) staff members, and all three (3) staff members denied the allegation. LPA interviewed three (3) clients, and two of three (3) clients could not corroborate the allegation. LPA interviewed one (1) witness and W1 stated that C1 can be difficult client at times and especially with certain female staff. One staff member stated that staff was assisting with C1 using the restroom had a seizure, staff then attempted to hold C1 up but C1 was too heavy and fell over to the floor. One client stated client heard noises but did not witness incident. C1 stated C1 was pushed to floor by a night shift staff but later during visit told LPA that it was S2. C1 stated incident happened on Friday when the incident occurred on a Monday. There are too many inconsistencies and lack of evidence to support this allegation.

Allegation: Staff member did not safeguard the personal possession of resident in care. It is alleged that one staff took C1 phone and tossed C1 phone. LPA interviewed three (3) staff, and all three (3) staff denied the allegation. LPA interviewed three (3) clients and two (2) of three (3) could not corroborate the allegation. There is no witnesses to the incident and not enough evidence to support this allegation.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED

Exit interview conducted and copy of report provided to staff. .

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2