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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000897
Report Date: 09/28/2022
Date Signed: 09/28/2022 12:21:03 PM


Document Has Been Signed on 09/28/2022 12:21 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:MARINA CHILDRENFACILITY NUMBER:
384000897
ADMINISTRATOR:MARTIN, CAMERONFACILITY TYPE:
850
ADDRESS:3219A LAGUNA STREETTELEPHONE:
(415) 931-0833
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94123
CAPACITY:21CENSUS: 11DATE:
09/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Cameron MartinTIME COMPLETED:
12:35 PM
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On 9/28/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Marina Children Center. The LPA was granted entry by the Director, Cameron Martin. The LPA explained the purpose of the visit to the director. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed the director, one teacher and one assistant supervising eleven preschool children. Children's capacity and ratio requirements were observed to be in compliance,

LPA and the director both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA made the observation that the playground equipment and outdoor furnishings are in very good shape. The outdoor play structures are surrounded by artificial grass, which can cushion any falls that may occur. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order. The director has stated that the facility does not house any firearms or other types of weapons.



The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

The LPA reviewed the records of eleven children. All required forms were in the children’s’ file. The program uses a sign in / out sheet for authorized individuals to sign their children in and out.

***See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2022
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MARINA CHILDREN
FACILITY NUMBER: 384000897
VISIT DATE: 09/28/2022
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Continued, Page 2
The LPA reviewed the records of three staff members. All required forms were in the staff files. A review of staff records revealed that one staff member is currently certified in CPR and First Aid.

According to the director, the facility simulates and documents fire and earthquake drills monthly. .

The director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



Incidental Medical Services (IMS) policy was discussed with the director. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The LPA encouraged the director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

A copy of this report, and the “Notice of Site Visit” were given to the director.

A Notice of Site Visit must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Cameron Martin

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
LIC809 (FAS) - (06/04)
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