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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 496804187
Report Date: 08/03/2026
Date Signed: 08/03/2026 02:37:12 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/24/2026 and conducted by Evaluator Marisol Cuadra
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20260724103832
FACILITY NAME:COTTONWOOD COMMUNITY SUPPORT HOMEFACILITY NUMBER:
496804187
ADMINISTRATOR:HAYES, TESS R.FACILITY TYPE:
735
ADDRESS:411 COTTONWOOD DR.TELEPHONE:
(707) 623-8025
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY:4CENSUS: 3DATE:
08/03/2026
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Tess Hayes (Licensee)TIME COMPLETED:
02:52 PM
ALLEGATION(S):
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-Staff did not ensure resident's cash resources were safeguarded.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cuadra conducted an unannounced visit and met with Licensee Tess Hayes. LPA came to the facility to investigate and deliver findings of complaint allegation listed above.

The department received an allegation of staff did not ensure resident's cash resources were safeguard. Per Reporting Party, client (C1) was financially exploited by an alleged abuser who is unknown individual (I1) online scammer that reached out to C1 through an online gaming platform promising to help C1 prosper in online gaming. I1 communicated with C1 over WhatsApp and C1 gave I1 approximately $2000 throughout the past four to five months for services that were not provided. I1 threatens C1 for money, stating: "if you don't do this then I'm going to do this to your gaming account." Per the reporting party, they have stopped C1 from giving I1 their account and bank information. Also, they have advised C1 to block I1 and delete the communications, but C1 said "I blocked them, but I unblocked them for some reason." LPA conducted 10-day complaint investigation visit at the facility on 08/03/2026 and obtained documents, made observations, and conducted interviews. Continue on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026
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-20260724103832
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: COTTONWOOD COMMUNITY SUPPORT HOME
FACILITY NUMBER: 496804187
VISIT DATE: 08/03/2026
NARRATIVE
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Continued from LIC9099...

During the visit, LPA obtained copies of C1’s physician’s report dated 12/16/25, which indicated that C1 is able to manage their own cash resources and a signed Individual Program Plan (IPP) dated 6/20/24 from placement agency which states that C1 doesn’t qualify for payee representative to manage their finances, so they manage their own cash resources. Per C1’s IPP, they have a history of mismanaging their finances due to excessive involvement in online gaming, but C1 could manage their own finances. The facility provided C1’s record of client’s safeguard cash resources that indicates the date when C1 receives their P & I fund, Licensee documents the amount on the facility ledger as 0, then Licensee takes them to cash the check and C1 stores it themselves. According to C1’s annual progress report dated 06/20/26, objective #6 regarding C1’s financial obligations was dropped due to C1 decided to keep their financial status private and not share accurate information with the facility, where it states that C1 receives money management support from behaviorist counseling vendor to help them to establish their budget. The facility uses these services of a Board-Certified Behavior Analyst (BCBA) as outlined in Title 22 regulations to help C1 to manage their behaviors. C1’s responsible party is also involved with C1’s finances and has raised concerns related to their spending pattern. Based on interviews conducted with C1, confirmed above information and stated that they feel safe at home, they stated that its their understanding that if I1 attempts to scam them again, they will tell them that they don't have any money. Based on record review and interviews conducted with C1 and Licensee, LPA was able to determine that C1 has a known documented history of mismanaging their money, its currently receiving support for their behavior and the facility is not responsible for safeguarding their cash resources. Based on record review, interviews conducted, and observations made, the allegation that the staff did not ensure resident's cash resources were safeguarded is UNSUBSTANTIATED. A finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2