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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 11:17:41 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
07/10/2023 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230710143710
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:12CENSUS: 2DATE:
07/11/2023
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Pamela MazzaTIME COMPLETED:
11:17 AM
ALLEGATION(S):
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Licensee abandoned day care children at a park.
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 abandoned day care children at a park. LPAs met with Licensee, Pamela Mazza (L1).

On 07/10/23 the Department received a direct witness statement from Adult 1 (A1) that on an undisclosed date at an undisclosed time, A1 witnessed L1 walking with two female children to the small community garden near L1’s home address. A1 stated that when they observed L1 walking back home with her garden “stuff”, they didn’t think much of it until they heard two girls calling, “Pam! Pam!”. A1 stated that they waited for a couple of seconds and heard it again and then observed two girls walking over a small creek bridge toward A1, unsupervised. A1 stated that L1 must have left the garden without the girls and walked home. A1 stated that they rode their bike with the girls to L1’s home to be sure that L1 was there and that the girls got home safely, and confirmed that L1 was in fact home.

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: 1 of 3
Control Number 01-CC-20230710143710
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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Based on witness A1’s statements, 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: 3 of 3
Control Number 01-CC-20230710143710
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
HSC
1597.58(c)(2)
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1597.58(c)(2) Absence of supervision, including, but not limited to, a child left unattended and a child left alone with a person under 18 years of age.

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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Based on witness observation, Licensee left two children at the small community garden near L1’s home unattended without supervision.
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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: 2 of 3