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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200313
Report Date: 04/07/2023
Date Signed: 04/07/2023 03:01:47 PM

Document Has Been Signed on 04/07/2023 03:01 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:COLE VOCATIONAL SERVICES PINOLEFACILITY NUMBER:
079200313
ADMINISTRATOR:SHANISHIA EVANSFACILITY TYPE:
775
ADDRESS:2401-A SAN PABLO AVETELEPHONE:
(510) 724-7190
CITY:PINOLESTATE: CAZIP CODE:
94564
CAPACITY: 45CENSUS: 39DATE:
04/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Shanishia Evans, AdministratorTIME COMPLETED:
03:20 PM
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On 04/07/2023 at 09:50 AM, Licensing Program Analyst (LPA) C. Fowler arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Program Director, Shanishia Evans and explained the purpose of the visit. Day program operates from 9:00AM to 3:00PM. There were 6 staff observed working with the 39 clients here today.

LPA toured facility with PD Shanishia Evans including but not limited to, multiple activity rooms, kitchen, bathrooms and office space. Clients bring their own lunches and snacks. Emergency supplies, including water were observed. The hot water temperature in the client bathroom measured 113.4 degrees Fahrenheit. Cleaning supplies are locked and inaccessible to clients. Medications are not handled/dispensed by this program at this time. There are no bodies of water or fire safety hazards observed. Restrooms are maintained in safe and in sanitary operating condition, and additional equipment for the physically handicapped was observed. Incontinent clients are kept clean and dry, and the facility is free of odors. LPA Reviewed client and staff files for sampling. Emergency disaster drills are conducted bi-annually and fire drills on a monthly basis. Fire extinguishers throughout facility were last inspected 11/21/2022. First aid kit was checked.

The following forms to be updated and submitted to CCL by 04/17/2023:

LIC 309 Administrative Organization


No deficiencies were cited during this inspection.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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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