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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209011
Report Date: 11/13/2025
Date Signed: 11/13/2025 01:03:01 PM

Document Has Been Signed on 11/13/2025 01:03 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 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: 41DATE:
11/13/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Mayra VelazquezTIME VISIT/
INSPECTION COMPLETED:
01:26 PM
NARRATIVE
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On November 13, 2025, at 11:45AM Licensing Program Analyst (LPA) Cynthia Alvarez conducted a unannounced Case Management- Deficiencies inspection. LPA met with Site Supervisor Mayra Velazquez LPA was at the Center to conduct a Case Management- Incident inspection to obtain further information about a self-reported incident that occurred on October 27,2025, During that visit LPA observed the construction on the school site, there has been an area removed from the preschool's playground.

LPA conducted interview with Site Supervisor and it was determined that the facility did not notify the department of the alterations and construction being done. LPA informed the Site Supervisor that any construction/alterations need to be reported to the department prior to construction/alterations being made. Site Supervisor stated the construction/alterations started during the on March 18, 2025, when the construction company delivered the material they would be utilizing during the construction. Site Supervisor stated that one June 13, 2025 the patch of their playground, specifically the grass area was fenced off and removed square footage of the playground. Site Supervisor also stated that there has not been any disruptions to the center as the construction company only shut down the water and electricity after the children have gone home. LPA advised Site Supervisor to submit in writing a plan to ensure the children are kept safe and separate from the construction and the time frame from when contraction started and to be completed. LPA also instructed Site Supervisor to submit a statement indicating they are now aware of the reporting requirement and will report any incident to the department within 24 hours.

LPA provided Site Supervisor with Title 22 Division 12 101237 Alterations to Existing Buildings or New Facilities, also LPA provided Provider Information Notification (PIN) 23-20-CCP.

During today's inspection, 2 Type B deficiency under Title 22 Division 12 was cited as a result of the construction occurring on site, which can be found on the attached 809-D.



Exit interview conducted and report was reviewed with Site Supervisor Mayra Velazquez.
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)
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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)
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Document Has Been Signed on 11/13/2025 01:03 PM - It Cannot Be Edited


Created By: Cynthia Alvarez On 11/13/2025 at 12:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CDR - MARINA WEST
FACILITY NUMBER: 566209011

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/13/2025
Section Cited

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101237 Alterations to Existing Buildings or New Facilities
(a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s).

This requirement is not met as evidenced by:
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Based on oberservations and interview the Center did not notify the Department about the construcion that altered the playground size which poses a potential Health and Safety risk to persons in care
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Type B
11/13/2025
Section Cited

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Reporting Requirements
(c) The licensee shall notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions.

This requirement is not met as evidenced by:
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Based on oberservations and interview the Center did not notify the Department of the construction that was occuring at the center, construction started in March 18, 2025, which poses a potential Health and Safety risk to persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Susana Martinez
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Alvarez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2025


LIC809 (FAS) - (06/04)
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