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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216803883
Report Date: 11/20/2023
Date Signed: 11/20/2023 03:13:36 PM

Document Has Been Signed on 11/20/2023 03:13 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MARIN VENTURESFACILITY NUMBER:
216803883
ADMINISTRATOR:RAYMOND CASHELFACILITY TYPE:
775
ADDRESS:10 JOSEPH COURTTELEPHONE:
(415) 472-4961
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 75CENSUS: 51DATE:
11/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Raymond Cashel, AdministratorTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived at Marin Ventures for the purpose of conducting an Unannounced Required 1 year inspection. LPA was met at the door by staff who showed LPA to office for sign-in and screening. There were 51 clients in attendance at the time of inspection.

LPA was met by Administrator Raymond Cashel, who reviewed the program with LPA and provided staff and client folders for review.

LPA toured the facility with Creative Arts Director, Tim Park. Facility is a one floor building. Hot water temperature checked between 113 - 117 degrees F. The facility has a phone line designated for client use. There was an ample supply of personal hygiene products. The facility includes kitchen equipped with a small refrigerator; art, drawing & painting room, conference room, activity rooms, storage, offices, laundry, and client's & staff bathrooms. Client & staff records, medication, first aid supplies, and toxins are locked and inaccessible on this level. There are six restrooms on this floor designated as female & male with two having a changing room. Clients bring their own food. Facility does not handle client funds.

LPA requested the following documents to be sent to Community Care Licensing: LIC 308, LIC 500, and Proof of Liability Insurance.

There were no citations issued. LPA will continue Annual Inspection at a later time.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
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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