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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093609172
Report Date: 10/23/2019
Date Signed: 10/28/2019 09:41:48 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SHERIDAN, MARIAN CAROLFACILITY NUMBER:
093609172
ADMINISTRATOR:SHERIDAN,MARIAN CAROLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 939-0334
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:14CENSUS: 10DATE:
10/23/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Marian Carol SheridanTIME COMPLETED:
03:40 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Jan Hoshida and Michelle Pascual, conducted a Case Management inspection regarding a citation from 9/12/19. LPAs met with Licensee, Marian Carol Sheridan.

Staffing Ratio and Capacity. If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). On 9/12/19, LPA Sierra observed Licensee caring for eight children (four infants and four preschool children).

During today's inspection, LPAs Hoshida and Pascual observed Licensee caring for ten children (four infants and six preschool children) without a qualified assistant.

Exit interview was conducted, Appeal Rights were discussed and Notice of Site Visit was posted.

This is an amended report.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SHERIDAN, MARIAN CAROL
FACILITY NUMBER: 093609172
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/24/2019
Section Cited

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102416.5 (e) Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
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This requirement was not met as evidenced by: LPAs observed Licensee caring for ten children (four infants, six preschool) without a qualified assistant. This poses an immediate risk to the health and safety of the children 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.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2019
LIC809 (FAS) - (06/04)
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