274400484-2-20-2025-07-CC-MMOO-DE3SRX-20250220130704

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274400484
Report Date: 02/20/2025
Date Signed: 02/20/2025 01:07:08 PM

Document Has Been Signed on 02/20/2025 01:07 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MARINA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	274400484
ADMINISTRATOR/ DIRECTOR:	LIZELLE WULFF		FACILITY TYPE:	850
ADDRESS:	3066 LAKE DRIVE		TELEPHONE:	(831) 384-0255
CITY:	MARINA	STATE: CA	ZIP CODE:	93933
CAPACITY: 132	TOTAL ENROLLED CHILDREN: 115	CENSUS: 95	DATE:	02/20/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:37 AM
MET WITH:	Sharon Valencia		TIME VISIT/ INSPECTION COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs), Marilou Monico and Jennifer Beehler conducted a Case Management Inspection in response to Licensee's request to change the capacity from 132 to 155 children in the preschool program. LPAs toured the indoor and outdoor areas as well as measured the space available for the children. INDOOR MEASUREMENTS: ROOM 1: 26.42 x 34.42 = 909.38 minus 53.83 (encumbered space) = 855.55 ROOM 2: 26.33 x 34.50 = 908.39 minus 53.83 (encumbered space) = 854.56 ROOM 3: 26.33 x 34.50 = 908.39 minus 80.67 (encumbered space) = 827.72 ROOM 5: 31.33 x 28.58 = 895.41 minus 61.57 (encumbered space) = 833.84 ROOM 6: 31.33 x 28.58 = 895.41 minus 65.00 (encumbered space) = 830.41 ROOM 7: 31.33 x 28.50 = 892.91 minus 54.00 (encumbered space) = 838.91 ROOM 15: 28.58 x 31.58 = 902.56 minus 81.90 (encumbered space) = 820.66 TOTAL PRESCHOOL INDOOR SPACE: 5,861.63 sq. ft. divided by 35 sq. ft. = 167 children OUTDOOR MEASUREMENTS: PRESCHOOL PLAYGROUNDS: 77.42 x 140.00 = 10,838.80 77.58 x 110.42 = 8,566.38 88.42 x 110.42 = 9,763.34 TOTAL PRESCHOOL OUTDOOR SPACE: 29,168.51 minus 1,182.42 (encumbered space) = 27,986.10 sq. ft. divided by 75 sq. ft. = 373 children Continuation on next page:

Gladys Kuizon	TELEPHONE: (510) -56-5850
Marilou Monico	TELEPHONE: (408) 334-8549
	DATE: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MARINA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 274400484
	VISIT DATE: 02/20/2025

NARRATIVE

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There are 15 sinks (225), 8 toilets (120), and 3 urinals (45) available for the children. There are staff bathrooms located in the Main Office and adjacent to Room 15. The staff bathroom located in the Main Office will be utilized by sick children if needed. The sick children will be isolated in the Nurse's Office in the Main Office Building and isolation equipment is provided. Cleaning supplies are stored inaccessible to children. There are 160 cubbies, 214 chairs, 31 tables, 47 cots and 87 mats. Some of the children will be attending on a part time basis and will not nap at the center. Drinking water indoor and outdoor is via water jugs and disposable cups. There are trash cans with tight fitting covers in the classrooms for the disposable of solid wastes. LPAs observed functioning smoke and carbon monoxide detectors in each room.

Fire clearance was granted on September 17, 2024.

A license for 155 children in the preschool program will be approved upon receipt of the following:
1) Updated Application for a Child Care Center License (LIC 200A) with a capacity of 155 children signed by the authorized representative.
2) Designation of Facility Responsibility with original signature of licensee's authorized representative.
3) Missing paperwork for the Site Director: Personnel Report (LIC 500), Operations/Record Keeping orientation certificate, health screening report, Personnel Record (LIC 501), immunization record (pertussis and measles) with the director's name, proof of health and safety training with Nutrition and lead poisoning prevention.

As a result of this inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with Site Director, Sharon Valencia.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) -56-5850
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

LIC809 (FAS) - (06/04)

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