306000560-4-6-2026-22-AS-KSGH-DTUMKJ-20260507094046

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000560
Report Date: 04/06/2026
Date Signed: 04/06/2026 05:01:05 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/02/2026 and conducted by Evaluator Eboni Bentley

COMPLAINT CONTROL NUMBER: 22-AS-20260402122603

FACILITY NAME:	GARDEN VILLA		FACILITY NUMBER:	306000560
ADMINISTRATOR:	MARILES BORJA		FACILITY TYPE:	735
ADDRESS:	13031-13061 WILSON STREET		TELEPHONE:	(714) 537-1545
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92844
CAPACITY:	32	CENSUS: 29	DATE:	04/06/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Mariles Borja - Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility staff yelled at client
Facility staff pushed a client.

INVESTIGATION FINDINGS:

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On April 6, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced for the purpose of conducting an initial complaint investigation for the above allegations and deliver findings. LPA was greeted, introduced self, and was granted entry after stating the purpose of the visit to staff. Administrator (Admin) Mariles Borja was contacted via telephone, LPA stated the purpose of the visit, and Admin arrived shortly to assist.

During today’s visit, LPA conducted a tour of the facility with staff and observed no imminent health and safety issues. LPA obtained copies of facility documents and clients records including: client/staff rosters, Personnel Record (LIC500), Physician Reports, and needs and services plans.

CONTINUE TO LIC9099-C....

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026

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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Control Number 22-AS-20260402122603

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: GARDEN VILLA	FACILITY NUMBER: 306000560
	VISIT DATE: 04/06/2026

NARRATIVE

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The following was revealed during the course of the investigation:

Regarding the allegation, Staff yelled at client, it was alleged that Staff #1 (S1) yelled at Client #1(C1) after the client stopped speaking to them. Interviews were conducted with three staff, four clients and witnesses. The two staff that were present during the alleged incident did not corroborate the allegation, stating C1 was yelling at S1 and S1 did not raise their voice at C1. Three out of four clients interviewed denied the allegation. Client #2 (C2), stated C1 was the only person yelling, and S1 and just walked away.

Regarding the allegation, Staff pushed a client, it is alleged that Staff #1 pushed a client into a door frame during an incident. Based on the interviews, two out of two staff denied the allegation, stating there was no physical contact and S1 did not push C1. One out of two clients present corroborated this, with C2 stating S1 did not touch the C1, and S1 walked away without any physical contact. During interviews, three out of four clients indicated that they have never been yelled at or pushed by any staff.

Based on the observation made, interviews which were conducted, and the records that were reviewed, 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 following allegations: Staff yelled at client and Staff pushed a client are deemed UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was provided at exit.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026

LIC9099 (FAS) - (06/04)

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