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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216803883
Report Date: 04/04/2024
Date Signed: 04/04/2024 12:42:59 PM

Document Has Been Signed on 04/04/2024 12:42 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MARIN VENTURESFACILITY NUMBER:
216803883
ADMINISTRATOR/
DIRECTOR:		RAYMOND CASHELFACILITY TYPE:
775
ADDRESS:10 JOSEPH COURTTELEPHONE:
(415) 472-4961
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 75CENSUS: 34DATE:
04/04/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Raymond Cashel, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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At approximately 9:15 AM, Licensing Program Analysts (LPAs) Felias and Florio, arrived unannounced to conduct a Required - 1 Year Visit continuation, and met with Staff Member, Penny Peterson. Administrator, Raymond Cashel, came to front desk at approximately 9:20 AM. Upon arrival, LPAs were informed that the Day Program has about 60 clients that attend daily but that there were currently 34 Clients attending the program with 8 staff members on-site today. Facility is an Adult Day Program that provides activities to Individuals with Disabilities. Facility has an approved fire clearance for 30 non-ambulatory and 75 ambulatory clients for a total capacity of 75 clients.

LPAs reviewed staff and client files. During file review, LPAs observed that some staff files were missing proof of negative TB tests and some client files were missing Physician Reports and proof of a negative TB test (See Technical Violations, LIC9102, Regulations 82066(a)(10) and 82069(b)).

Facility's fire extinguishers were last inspected December 20, 2023. Facility has a hard wired fire alarm and sprinkler system that is directly connected to the local Fire Department. Facility's fire system was last inspected May 20, 2023. Facility's last fire drill was conducted February 2024.

Exit interview conducted. Copy of report, LIC9102 (Technical Advisory/Violation) discussed and provided to Administrator. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Julie Florio
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024
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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