<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209011
Report Date: 11/13/2025
Date Signed: 11/13/2025 11:28:50 AM

Document Has Been Signed on 11/13/2025 11:28 AM - 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 BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CDR - MARINA WESTFACILITY NUMBER:
566209011
ADMINISTRATOR/
DIRECTOR:
SUZANNE GODINEZFACILITY TYPE:
850
ADDRESS:2551 CAROB ST.TELEPHONE:
(805) 382-7470
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 34DATE:
11/13/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Mayra Velazquez TIME VISIT/
INSPECTION COMPLETED:
11:37 AM
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
On November 13, 2025, at 9:00AM , Licensing Program Analyst (LPA) Cynthia Alvarez made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPA met with Site Supervisor Mayra Velazquez to discuss an incident that was self reported to Community Care Licensing Division (CCLD) office by telephone call on October 28, 2025. LPA toured the yard area where the incident occurred and interviewed the Site Supervisor and staff involved in the incident.

On October 27, 2025, from 1:34 PM until 1:35 PM, a child was left unattended in the enclosed outdoor yard. Staff members were bringing the children inside from being in the outdoor playground. Site Supervisor states that children were lined up outside and were preparing them to come inside for snack On October 27,2025 at 1:34PM, children lined up, S1 was at the front of the line S2 was in the middle of the line and S3 was at the end of the line, all staff conducted a head count and counted for all 15 children present. Staff preceded to walk inside for children to wash their hands and eat their snack. At 1:35PM Site Supervisor walked in and saw C1 trying to open the locked gate to get into the classroom. Site Supervisor assisted child back to the classroom when they walked in, teachers had not realized child was left behind in the playground. C1’s parents were notified, and they stated this is typical behavior for them. The child returned to the center a few days later as they got sick and stayed home for a few days after the incident.

To prevent similar incidents, the center has implemented a lanyard system, children all have a lanyard with their picture on it and must hang it up along the playground so that they can go out and play and at the end of their playtime they must collect the lanyard to get in line, this will assist teachers in identifying id children have not been accounted for, also, staff member are doing a final sweep of the outdoor area, 2 formal trainings regarding active supervision strategies were held after the incident for staff and the staff members were counseled individually in regard to active supervision.

Given the child was left unattended for approximately 1 minute, and staff did not realize child was left unattended until Site Supervisor walked into the classroom with the child, one technical violation was given today.

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Appeal Rights were provided to Site Supervisor Exit interview conducted and report was reviewed with Site Supervisor Mayra Velasquez.

NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Cynthia Alvarez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 2