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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 490170634
Report Date: 07/11/2023
Date Signed: 07/11/2023 10:41:35 AM

Substantiated


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
07/03/2023 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230703095119

FACILITY NAME:MAZZA, PAMELA FAMILY CHILD CARE HOMEFACILITY NUMBER:
490170634
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:CENSUS: 2DATE:
07/11/2023
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Pamela MazzaTIME COMPLETED:
10:41 AM
ALLEGATION(S):
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Licensee is not able to meet day care children's needs
INVESTIGATION FINDINGS:
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On 07/11/23 at 9:10am Licensing Program Analysts (LPAs) Amy Strother and Robert Maciel arrived at the facility unannounced for the purpose of conducting a complaint investigation inspection. It was alleged that licensee is not able to meet day care children's needs. LPAs met with Licensee, Pamela Mazza (L1).

Prior to and following 02/14/23 L1 violated the California Child Day Care Facilities Act, as follows: L1 had an infant in care, but did not have an Individual Infant Sleeping Plan (LIC9227) for the infant; L1 did not have a sleep log for the infant in care; L1 did not conduct fire drills every six months as required; L1 did not have a current pediatric first aid or CPR certification; L1 did not have a current roster of children in care; and L1 did not have emergency cards for all children in care. On or about 01/17/23 the City of Santa Rosa Fire Inspector noted several violations at the facility which L1 failed to correct. On 03/01/23 the Department requested L1’s presence at the Regional Office for a 03/09/23 in-person meeting to address the ongoing violations which threaten the health, safety, and welfare of children in care, but L1 failed to participate.
Substantiated
Estimated Days of Completion:
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.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20230703095119
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: MAZZA, PAMELA FAMILY CHILD CARE HOME
FACILITY NUMBER: 490170634
VISIT DATE: 07/11/2023
NARRATIVE
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On 07/10/23 at 9:23am LPA conducted an interview with a parent (A9) of a child formerly in L1’s care who stated that during the month of May 2023, while in L1’s home, they witnessed multiple examples of L1’s behavior or decision making that was unsafe for the children in care, including allowing children to ride tricycles out in the cul-de-sac without supervision.

Based on LPAs observations on 02/14/23 and 03/01/23, interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12 & Chapter1), are being cited on the attached LIC9099D.

An exit interview was conducted, and Plan of correction was reviewed with the Licensee. Appeal Rights were provided and discussed with, Pamela Mazza whose signature on this form confirm receipt of these documents.
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
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20230703095119
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: MAZZA, PAMELA FAMILY CHILD CARE HOME
FACILITY NUMBER: 490170634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/11/2023
Section Cited
CCR
102402(a)(3)
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102402 Revocation or Suspension of a License or Registration (a)The Department shall have the authority to suspend or revoke any license for the following reasons: (3) Conduct in the operation or maintenance of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California.

This requirement has not been met as evidenced by:
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License has been revoked by the Department as of 06/26/23.
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Licensee did not correct several violations which threaten the health, safety, and welfare of children 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: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5