274400484-12-2-2019-07-CC-SKNT-BLQS67-20200212123526

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 274400484
Report Date: 12/02/2019
Date Signed: 12/02/2019 02:44:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/13/2019 and conducted by Evaluator Joseph Macias

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20191113113352

FACILITY NAME:	MARINA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	274400484
ADMINISTRATOR:	LIZELLE WULFF		FACILITY TYPE:	850
ADDRESS:	3066 LAKE DRIVE		TELEPHONE:	(831) 384-0255
CITY:	MARINA	STATE: CA	ZIP CODE:	93933
CAPACITY:	132	CENSUS: 102	DATE:	12/02/2019
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Jessica Boyce		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff failed to prevent illness from spreading.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joe Macias, conducted an unannounced inspection in order to deliver findings on the complaint investigation of above allegation. LPA Macias met with the Site Supervisor Jessica Boyce to discuss complaint allegation.

LPA Macias interviewed staff, and Complainant, observed the classroom, and obtained copies of pertinent information. Throughout the investigation process, it was found the allegation (staff failed to prevent illness from spreading) is UNSUBSTANTIATED; based on interviews, observation, and information gathered by LPA Macias. LPA could not find if the child did or did not contracted any illness at the facility. A finding that is unsubstantiated means although the allegation may have happened or is valid, the preponderance of evidence does not prove it.

Exit interview conducted and copy of this report provided to the Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019

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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