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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603371
Report Date: 11/18/2025
Date Signed: 11/18/2025 02:57:59 PM

Substantiated


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
11/14/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251114120114
FACILITY NAME:CANDLELIGHT HOME GARDENGLENFACILITY NUMBER:
198603371
ADMINISTRATOR:JANE CUAFACILITY TYPE:
735
ADDRESS:419 SOUTH GARDENGLEN STREETTELEPHONE:
(626) 715-5653
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:4CENSUS: 4DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Estrella Mactiag, Direct Service ProviderTIME COMPLETED:
02:59 PM
ALLEGATION(S):
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Staff did not ensure residents’ privacy.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez made unannounced visit to investigate the above-mentioned allegations: LPA met with Estella Macating, DSP and discussed the purpose of today’s visit.

The investigation consisted of taking a tour of the home inside and out, reviewing and obtaining client and staff rosters and interviewing three (3) staff, S#1 – S#3, and four (4) clients (C#1 – C#4). Regional Center Notes.

The investigation revealed regarding allegation: Staff did not ensure residents’ privacy. It is alleged that staff tied bathroom door handle to towel rack to prevent it from closing due to one client slamming it and clients could not maintain privacy while using the restroom. LPA interviewed three (3) staff and all three staff admitted to the door being tied. S1 stated it was because it was broken and to prevent one client from slamming the door. S2 stated S2 tied it because it was coming off the hinges and due to slamming from another client. S2 stated S2 fixed it and removed tie after speaking with Administrator. (continued on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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 5
Control Number 28-AS-20251114120114
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: CANDLELIGHT HOME GARDENGLEN
FACILITY NUMBER: 198603371
VISIT DATE: 11/18/2025
NARRATIVE
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(continued from 9099)

Administrator stated it was only tied open for a short time to prevent the door being slammed by another client. LPA interviewed four (4) clients and all three (3) of four (4) clients stated that the bathroom door was tied for a short period of time only. Photo of bathroom door being tied was obtained during visit. There is sufficient evidence to substantiate this allegation.

Based on LPAs observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

Exit interview held, and a copy of this report was provided along with appeal rights.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
11/14/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251114120114

FACILITY NAME:CANDLELIGHT HOME GARDENGLENFACILITY NUMBER:
198603371
ADMINISTRATOR:JANE CUAFACILITY TYPE:
735
ADDRESS:419 SOUTH GARDENGLEN STREETTELEPHONE:
(626) 715-5653
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:4CENSUS: 4DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Estrella Mactiag, Direct Service Provider. TIME COMPLETED:
02:59 PM
ALLEGATION(S):
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Staff restricted residents’ access to the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez made unannounced visit to investigate the above-mentioned allegations: LPA met with Estella Macating, DSP and discussed the purpose of today’s visit.

The investigation consisted of taking a tour of the home inside and out, reviewing and obtaining client and staff rosters and interviewing three (3) staff, S#1 – S#3, and four (4) clients (C#1 – C#4).

Allegation: Staff restricted residents’ access to the facility. It is alleged that staff placed a chair in behind the side gate that prevented clients from entering and exiting facility. LPA interviewed three (3) staff, and all three staff denied the allegation. One staff member stated that it was a client that placed the chair in front of side door. LPA interviewed four (4) client and all three (3) of four (4) could not corroborate the allegation. LPA inspected side door and there was no chair blocking access, however, the side door was observed to be broken and would not open without striking the electric meter cover which impeded the door from opening.
(continued on 809C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20251114120114
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: CANDLELIGHT HOME GARDENGLEN
FACILITY NUMBER: 198603371
VISIT DATE: 11/18/2025
NARRATIVE
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(continued from 9099A)


This deficiency is addressed on case management report. There is insufficient evidence to support this allegation.

Based on observations, statements and interviews conducted with staff, clients, there was not enough supportive evidence to concur with the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview held and a copy of this report was provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20251114120114
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: CANDLELIGHT HOME GARDENGLEN
FACILITY NUMBER: 198603371
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2025
Section Cited
CCR
80072(a)(1)
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Personal Rights. Each clients has the right to be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter. This requirement is not met as evidenced by:
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Administrator will provided personal rights training to all staff and send proof to LPA with signatures of all staff on the training roster.
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Based on statements from clients and staff and photo obtained, bathroom door was tied open from the knob to the towel rack behind the door and it prevented clients from having privacy during use of bathroom.
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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: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5