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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620599
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:32:17 PM

Document Has Been Signed on 05/10/2023 12:32 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:DOLAR, PRISCILLAFACILITY NUMBER:
343620599
ADMINISTRATOR:DOLAR, PRISCILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 515-2030
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
05/10/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Priscilla DolarTIME COMPLETED:
12:45 PM
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On May 10th, 2023, Licensing Program Analyst (LPA) Arianna Manabat met with Licensee Priscilla Dolar for the purpose of an unannounced Plan of Correction (POC) visit. The purpose of today's visit was explained to the licensee. Everyone subject to a criminal background clearance has obtained one and is cleared. Previously, LPA Manabat had cited the Licensee for exceeding ratio during the annual inspection conducted on 05/04/2023. During that visit, LPA observed the Licensee caring for ten children alone.

During today's visit, LPA has observed that the Licensee has corrected this citation and is abiding by Title 22 regulations as LPA Manabat has observed a total of 11 children in care with the Licensee, her assistant, and husband. In addition, LPA Manabat has observed the Licensee obtain signed Acknowledgement of Receipt forms LIC 9224) from all enrolled families in the facility. Based off observations and record review, LPA Manabat has cleared the deficiency for ratio as the licensee is operating within ratio and capacity.

The Licensee was issued a "Letter of Deficiency Citations Cleared" indicating the cleared citation. An exit interview was conducted and appeal rights were given. A notice of site visit form was issued and the Licensee was informed that it must remain posted for 30 days. The Licensee is aware that failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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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