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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486800855
Report Date: 08/20/2026
Date Signed: 08/20/2026 02:33:37 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/23/2026 and conducted by Evaluator Elias Magdaleno
COMPLAINT CONTROL NUMBER: 21-AS-20260423131419
FACILITY NAME:HIGHLANDS CARE HOME IVFACILITY NUMBER:
486800855
ADMINISTRATOR:SALVADOR, MARIAFACILITY TYPE:
740
ADDRESS:333 FORESTHILL DRIVETELEPHONE:
(707) 731-0803
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY:6CENSUS: 6DATE:
08/20/2026
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Lolita Pimental, CaregiverTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Lack of Supervision
Personal Rights
INVESTIGATION FINDINGS:
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At approximately 12:20PM Licensing Program Analyst (LPA) Magdaleno arrived unannounced to deliver findings regarding the above allegations and met with Caregiver Lolita Pimental. Administrator Maria Salvador was contact via telephone and gave permission for caregiver to sign and receive report.

Lack of Supervision, Personal Rights - Complaint alleges that due to lack of supervision, residents were using illegal drugs in the facility and at least one resident was providing drugs to at least another resident. Alleged activity resulted in resident eloping from the facility due to another resident requesting money from them to buy drugs. Three of four residents interviews denied drug use in the home while the fourth resident did not answer the question. A fifth resident refused to be interviewed. Two of three staff interviewed reported suspicions that residents were using drugs in the home but denied seeing drugs being used in the home. Review of Plan of Operation and Facility Policies indicated that potential risks to resident health and safety shall be reported.
Continued LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
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 2
Control Number 21-AS-20260423131419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HIGHLANDS CARE HOME IV
FACILITY NUMBER: 486800855
VISIT DATE: 08/20/2026
NARRATIVE
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Continued from LIC9099...

Staff reported that they don’t have a policy for how often residents are checked on. Although the allegations may have happened or are valid, the Department has found there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated.


Exit interview conducted with Caregiver, whose signature on form confirms receipt.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2