275202480-2-17-2026-24-AS-SMOA-DRFMAM-20260219082634

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202480
Report Date: 02/11/2026
Date Signed: 02/17/2026 09:44:15 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/30/2025 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20251230100053

FACILITY NAME:	CARMELO PARK		FACILITY NUMBER:	275202480
ADMINISTRATOR:	MAZERIK, MATTHEW		FACILITY TYPE:	740
ADDRESS:	966 CARMELO STREET		TELEPHONE:	(831) 375-0665
CITY:	MONTEREY	STATE: CA	ZIP CODE:	93940
CAPACITY:	40	CENSUS: 28	DATE:	02/11/2026
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Administrator Karie Mazerik		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Resident sustained unexplained injury due to staff neglect/lack of supervision

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 02/11/2026, Licensing Program Analyst (LPA) V Gorban arrived unannounced to deliver findings on the above allegation. LPA introduced self, stated the purpose of the visit to administrator Karie Mazerik and was granted entry.

During the course of the investigation, LPA conducted a facility tour and conducted records review and interviews.
This agency has investigated the complaint alleging: Resident sustained unexplained injury due to staff neglect/lack of supervision. Based on interviews and records review no indications resident sustained injury due to neglect/and lack of supervision. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
No deficiencies issued during this visit, exit interview conducted, report signed and copy of this report provided for facility records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

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 1