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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455406502
Report Date: 05/22/2024
Date Signed: 05/22/2024 01:40:54 PM

Document Has Been Signed on 05/22/2024 01:40 PM - 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:MAZZANTI, JENNA FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406502
ADMINISTRATOR/
DIRECTOR:		MAZZANTI, JENNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 949-4460
CITY:COTTONWOODSTATE: CAZIP CODE:
96022
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:02 PM
MET WITH:Jenna MazzantiTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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An unannounced case management inspection was conducted today at 1:02 pm by Licensing Program Analyst (LPA), Bianca Mendez. LPA met with licensee Jenna Mazzanti. In response to an Unusual Incident Report received by the Department on 5/14/24. Child (C1) was outside grabbing onto the wired fence when the neighbor's dog came and hit the fence and bit the child on the back of the left hand.

The licensee was interviewed on 5/22/24 at 1:02pm and stated that on 5/14/24 at 3:25pm, the children were playing outside in the backyard when Child (C1) was grabbing onto the wired fence, the neighbor was transitioning the dog kennel into their own house when their dog ran into the fence and resulted in biting C1 as they grasping onto the wired fence. C1 sustained bruising and scratching and needed a stitch. Licensee stated that the child did receive medical attention and had immediately notified the family when the incident occurred. Licensee stated that they were present with the children and had heard the neighbor's dog barking but did not see the incident when it occurred. Licensee stated that the neighbor's dog is currently under quarantine for 10 days by order of Animal control.Licensee did block some of the fencing in their backyard between their fence and the neighbor's fence.


SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: MAZZANTI, JENNA FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406502
VISIT DATE: 05/22/2024
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During today’s inspection, the facility was toured. LPA observed 9 children in care and some children were napping. LPA observed C1's left back hand was bruised with a stitch

Based on information and interview reported. It could not be determined the serious injury occurred due to lack of supervision.

Exit interview conducted and report was reviewed with the licensee Jenna Mazzanti Appeal Rights were provided. There were no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC809 (FAS) - (06/04)
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