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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343625486
Report Date: 10/09/2025
Date Signed: 10/09/2025 02:09:50 PM

Substantiated


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
07/15/2025 and conducted by Evaluator Loraine Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250715144539
FACILITY NAME:PEARSON, FATMATAFACILITY NUMBER:
343625486
ADMINISTRATOR:PEARSON, FATMATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 698-3896
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:14CENSUS: DATE:
10/09/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Fatmata PearsonTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Licensee handled a child in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Loraine Perez met with Licensee Fatmata Pearson, for the purpose of conducting an unannounced subsequent complaint investigation inspection pertaining to the above allegation. The purpose of today's inspection was explained to the Licensee.
During today's inspection, LPA observed care, and obtained relevant documentation.

Based on LPA observation of evidence shared with the department, the Licensee moved a child by holding the child's elbow, holding the child's arm extended up and walked together to the bathroom.
The preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
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 03-CC-20250715144539
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PEARSON, FATMATA
FACILITY NUMBER: 343625486
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/10/2025
Section Cited
CCR
102423(a)(4)
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To be free from corporal or unusual punishment, ... or other actions of a punitive nature, including, but not limited to: interference with... toileting; or withholding shelter, clothing, ...
This requirement is not met as evidenced by:
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Licensee stated she shall respect their space and handle children with caution and gentle care. LPA shall return for a plan of correction visit.
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Based on observation, the licensee did not comply with the section cited above, Licensee moved a child by holding their elbow above their head, which poses a immediate health, safety risk to persons 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: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20250715144539
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PEARSON, FATMATA
FACILITY NUMBER: 343625486
VISIT DATE: 10/09/2025
NARRATIVE
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The Licensee was informed that this report dated 10/09/2025 documents one Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in each child's file for verification.

Exit interview was conducted and a copy of this report was given to the Licensee Fatmata Pearson. Notice of site was given and must remain posted for parental review for 30 days. Appeal rights were provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3