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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274400484
Report Date: 12/18/2025
Date Signed: 12/18/2025 03:13:59 PM

Document Has Been Signed on 12/18/2025 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MARINA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
274400484
ADMINISTRATOR/
DIRECTOR:		LIZELLE WULFFFACILITY TYPE:
850
ADDRESS:3066 LAKE DRIVETELEPHONE:
(831) 384-0255
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY: 155TOTAL ENROLLED CHILDREN: 155CENSUS: 99DATE:
12/18/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Lazaro CamargoTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On December 18, 2025, Licensing Program Analyst Darnella Barnes conducted an unannounced annual inspection. The purpose of the visit was explained to Site Supervisor Lazaro Camargo, who granted access and received the Entrance Checklist (LIC 125). At the time of inspection, Site Supervisor Lazaro Camargo, Site Supervisor Ashley Reyes, two administrative staff, eighteen teachers, and ninety-nine children were present.

The center used Rooms 1, 2, 3, 5, 6, 7, and 15 on campus. The facility operated part-time and full-time programs Monday through Friday from 7:00 a.m. to 4:00 p.m. Meals were provided by the Seaside High School Production Kitchen and delivered daily. Breakfast, lunch, and afternoon snack were provided. Filtered water was available for children.

All required postings were visible. The most recent fire drill was conducted on December 11, 2025. LPA reminded the Site Supervisor of the six-month fire drill requirement and documentation. Fire extinguishers rated 30-40-BC were present in classrooms, offices, and other areas of the campus and were last serviced on July 18, 2025. Each classroom and office contained a carbon monoxide detector and was equipped with a fire detection system. An operating telephone was present. The Site Supervisor stated there were no firearms on the premises and that smoking was prohibited.

Fingerprint clearances for individuals requiring caregiver background checks were obtained through the State Department and/or County Office of Education and were not under the jurisdiction of the Community Care Licensing Division.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MARINA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 274400484
VISIT DATE: 12/18/2025
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The indoor environment was clean and maintained. Flooring was intact and free of hazards. Toy containers had smooth edges and secure lids. Each child had a labeled storage space. Mats made of wipeable material measuring at least one inch in thickness were observed, stored, and labeled with each child’s name. Bedding and coverings were washed weekly by the facility.

Bathroom facilities met the required ratio of one sink and one toilet per fifteen children. Toileting areas were cleaned and disinfected on a regular basis.

Cleaning supplies and chemicals were stored in locked cabinets and were inaccessible to children. Floors were mopped and carpets vacuumed daily. Trash was stored in covered containers. Indoor temperatures measured 68 degrees Fahrenheit in all rooms.

Five children’s files were reviewed and found complete. Files included the Admission Agreement, Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), Physician’s Report (LIC 701), immunization records, tuberculosis test results, Personal Rights (LIC 613A), Notification of Parent’s Rights (LIC 995A), and Pre-admission Health History.

Sign-in and sign-out records were completed using the HUBBE application and were reviewed. Records contained full legal signatures and accurate times.

Five staff files were reviewed. Each file contained Pediatric First Aid and CPR certification, Mandated Reporter Training, job application, health screening, child abuse reporting acknowledgment, employee rights form, and proof of qualifications. LPA reminded the Site Supervisor that Mandated Reporter Training must be renewed every two years and that one staff member must maintain current CPR and First Aid certification at all times. The LPA also reminded the Site Supervisor that aides and assistants must remain under the supervision of a qualified teacher, except during naptime or bathroom transitions.

During the outdoor inspection, walkways, ramps, and stairs were free of hazards. The play area had shade and was arranged to reduce risk. The outdoor area was fenced at least four feet high, free of debris, and contained no accessible hazards or bodies of water.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MARINA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 274400484
VISIT DATE: 12/18/2025
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First aid supplies were observed in a location accessible to staff and inaccessible to children. Supplies included a first aid manual, bandages, scissors, adhesive tape, a thermometer, tweezers, and antiseptic solution.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the Site Supervisor shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Classroom sinks were used for handwashing and cleaning only. Drinking water was provided through parent-supplied water bottles, classroom filtration systems, or a filtered water dispenser located in the main office.

Site Supervisor was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California..

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please inspection the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MARINA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 274400484
VISIT DATE: 12/18/2025
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No deficiency issued during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Appeals rights provided.

Exit interview was conducted, and the report was reviewed with Site Supervisor Ashley Reyes and Site Supervisor Lazaro Camargo.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC809 (FAS) - (06/04)
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