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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343618345
Report Date: 05/13/2026
Date Signed: 05/13/2026 11:26:14 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2025 and conducted by Evaluator Erwina Pascual-Golamco
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20251028165757
FACILITY NAME:MAZLOOM, ZIBAFACILITY NUMBER:
343618345
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
05/13/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ziba MazloomTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Day care child sustained unexplained fracture while in care.
Day care child sustained injuries due to licensee neglect.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erwina Pascual-Golamco met with Licensee (L), Ziba Mazloom, to deliver findings. The purpose of today's inspection was explained.
It was alleged that Day care child sustained unexplained fracture while in care and Day care child sustained injuries due to licensee neglect. The allegations were investigated by the Department's Investigations Branch (IB). During the investigation, IB interviewed licensee, staff, parents, and obtained documents. IB’s interviews, statements, and documentation were inconsistent to corroborate the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.
Exit interview was conducted and report was reviewed with Licensee, Ziba Mazloom. Appeal rights were provided, and a Notice of Site visit was given to Licensee, who will post it where visible to parents/guardians for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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