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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603800
Report Date: 01/21/2026
Date Signed: 01/21/2026 11:04:09 AM

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
01/14/2026 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260114130103
FACILITY NAME:CANDLELIGHT HOME BARTLETTFACILITY NUMBER:
198603800
ADMINISTRATOR:GIL CALINGASANFACILITY TYPE:
735
ADDRESS:3216 BARLETT AVETELEPHONE:
(626) 927-9253
CITY:ROSEMEADSTATE: CAZIP CODE:
91770
CAPACITY:4CENSUS: 4DATE:
01/21/2026
UNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Julie Ann Oviedo, DSPTIME COMPLETED:
11:12 AM
ALLEGATION(S):
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Staff did not dispense client's medication as required
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez made an unannounced visit to investigate the above-mentioned allegation. LPA met with Julie Ann Oviedo, DSP and discussed the purpose of the visit.

The investigation consisted of LPA taking tour of facility, interviewing two (2) staff S#1 – S#2 and attempted to interview four (4) residents but unable to due to cognitive impairments. LPA obtained staff and Client rosters, reviewed C1 medications, Corrective action plan (CAP) from Regional Center and Incident report.

The investigation revealed: Regarding Allegation: Staff did not dispense client's medication as required. It is alleged that on January 7, 2026, the PM dose of clonazepam was dispensed and given to C1. However, during the review by Regional Center staff on January 8, 2026, it was discovered that the medication remained in the bubble pack. (Continued on (9099C)


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
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 28-AS-20260114130103
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 BARTLETT
FACILITY NUMBER: 198603800
VISIT DATE: 01/21/2026
NARRATIVE
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(continued from 9099)

LPA interviewed two staff and both staff admitted to the medication error. LPA reviewed MAR for C1 and medication error was confirmed.



Based on LPAs 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 was 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: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260114130103
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 BARTLETT
FACILITY NUMBER: 198603800
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/28/2026
Section Cited
CCR
80075(b)
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80075(b) Health Related Services. Medications shall be given according to physician's directions.

This requirement is not met as evidenced by:
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Facility Administrator will conduct in-service on administration of medications for all staff that administer medication and will create a written plan explaining how facility will make sure medications are administered following physicians orders and how often training will be conducted with staff.
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On January 7, 2026, the PM dose of clonazepam was dispensed and given to C1. However, during the regional center review on January 8, 2026, it was discovered that the medication remained in the bubble pack which posed/posses a potential health and safety 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: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3