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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203245
Report Date: 08/22/2022
Date Signed: 08/22/2022 12:12:22 PM

Document Has Been Signed on 08/22/2022 12:12 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:COLE VOCATIONAL SERVICES BAKERSFIELDFACILITY NUMBER:
157203245
ADMINISTRATOR:STEWART-MARTIN, AUDREYFACILITY TYPE:
775
ADDRESS:7500 DISTRICT ST STE BTELEPHONE:
(661) 834-9300
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 105CENSUS: 100DATE:
08/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Audrey Stewart-Martin, AdministratorTIME COMPLETED:
12:20 PM
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On 08/22/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA met with Administrator Audrey Stewart and stated the purpose of the visit.

Upon entry facility staffs was observed with facial mask. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to clients and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed social distancing and cough etiquette postings in facility.

LPA and Administrator observed cart with cleaning chemicals in unlocked empty room and paint cans in unlocked storage room. LPA observed a 30-day PPE supplies. Staffs have current First Aid/CPR training certificates. A sample of clients’ records reviewed to have updated emergency contact information.

A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 08/29/22. The following updated forms were requested: Lic 308, Lic 309, Lic 400, and Lic 402 (if applicable). A copy of this report and appeal rights was provided to Administrator.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2022
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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Document Has Been Signed on 08/22/2022 12:12 PM - It Cannot Be Edited


Created By: Mai Yang On 08/22/2022 at 11:44 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: COLE VOCATIONAL SERVICES BAKERSFIELD
FACILITY NUMBER: 157203245

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)(3)
Disinfectants, cleaning solutions, poisons, and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, at 11:00 AM LPA and Administrator observed in unlocked empty facility room a cart full of cleaning chemicals. At approximately 11:04 AM, LPA and Administrator observed paint cans in unlocked storage room with door opened accessible to clients in care this poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/23/2022
Plan of Correction
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Administrator immediately removed the cart of chemicals and paint cans into locked storage room by the entrance. POC cleared during visit.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Melinda Hoffmann
LICENSING EVALUATOR NAME:Mai Yang
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2022


LIC809 (FAS) - (06/04)
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