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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 490170634
Report Date: 07/11/2023
Date Signed: 07/11/2023 11:26:46 AM

Document Has Been Signed on 07/11/2023 11:26 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MAZZA, PAMELA FAMILY CHILD CARE HOMEFACILITY NUMBER:
490170634
ADMINISTRATOR:MAZZA, PAMELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 539-7461
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
07/11/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Pamela MazzaTIME COMPLETED:
11:35 AM
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An unannounced site visit was made by Licensing Program Analysts (LPAs) Amy Strother and Robert Maciel to the above address and residence of Pamela Mazza. A legal Decision and Order of the license revocation has been received. The license for this facility has been revoked, effective 06/26/23. A visit was made to the facility by, LPAs Strother and Maciel to ensure licensed child care is no longer being provided. During today's visit, Mazza was providing exempt care to two children, siblings from the same family. Mazza stated she understands that care can only be provided to one family at a time to be exempt from licensure. Mazza was reminded that providing unlicensed child care is a violation of California Health and Safety Code Sections 1596.80 and 1597.54 and can result in the issuance of civil penalties and/or legal action to prevent such operation. A copy of the legal Accusation and Decision and Order was provided to Mazza.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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