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

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700082
Report Date: 08/25/2025
Date Signed: 08/25/2025 02:58:03 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/25/2025 02:58 PM - It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:SHERIDAN IN HOME CAREFACILITY NUMBER:
334700082
ADMINISTRATOR/
DIRECTOR:		SUSAN DOSTFACILITY TYPE:
300
ADDRESS:1555 S PALM CANYON 101-DTELEPHONE:
(760) 440-8540
CITY:PALM SPRINGSSTATE: CAZIP CODE:
92264
CAPACITY: CENSUS: DATE:
08/25/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Roxana Cordova, DesigneeTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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
Enforcement Analysts (EAs), Jane Cong-Huyen and Mila Quinto with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpose of a 2 year required licensing visit. The EAs met with HCO representative, Roxana Cordova. The EAs observed the posting of the license and operating business hours. Business operating hours are from 9am-1pm, Mondays.

During the inspection, the EAs reviewed personnel records for Home Care Aides including fingerprint status, registry status, Tuberculosis (TB), and required training(s). EAs also reviewed the HCO’s business records including document for designee in the absence of the licensee and insurance requirements were also reviewed during the visit.

EAs Cong-Huyen and Quinto found the HCO in compliance and no deficiencies were cited. An exit interview was conducted, and a copy of this report (HCS809) was provided to the HCO representative, Roxana Cordova, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 1