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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203245
Report Date: 11/14/2024
Date Signed: 11/14/2024 03:18:08 PM

Document Has Been Signed on 11/14/2024 03:18 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/
DIRECTOR:		STEWART-MARTIN, AUDREYFACILITY TYPE:
775
ADDRESS:7500 DISTRICT ST STE BTELEPHONE:
(661) 834-9300
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 105CENSUS: DATE:
11/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Program Director Audrey Stewart-MartinTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Shawna Doucette conducted an unannounced Case Management visit for an incident that occurred on 06/12/24/

LPA interviewed Program Director. Facility staff administered one feeding to C1, but did not administer the second feeding. Facility did not report incident.


See 809d for deficiencies.


A copy of this report with plan of correction and appeal rights were provided to the Program Director.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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 11/14/2024 03:18 PM - It Cannot Be Edited


Created By: Shawna Doucette On 11/14/2024 at 11:31 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: 11/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/15/2024
Section Cited
CCR
82092.1(a)(2)

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82092.1 General Requirements for Restricted Health Conditions (a) A client with a restricted health condition specified in Section 82092 may be admitted or retained if all of the following requirements are met:
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Plan of Correction POC Licensee agrees to submit a written statement on the understanding of this regulation and how it will be met by POC due date 11/15/24.
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(2) Care is provided as specified in this article. This requirement was not as evidenced by: Licensee did not administer C1's second feeding on 06/12/24, which poses an immediate health safety and or personal rights risks to clients in care.
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Type B
11/15/2024
Section Cited
CCR82061(a)

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82061 Reporting Requirements (a) Upon the occurrence, during the hours the day program is providing services to the client, of any of the events specified in Section 82061(a)(1), a report shall be made to the licensing agency within the
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Plan of Correction POC Licensee agrees to submit a written understanding on how this regulation will be met and will submit to Licensing by POC due date 11/15/24.
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agency's next working day during its normal business hours. In addition, a written report containing the information specified in Section 82061(a)(2) shall be submitted to the licensing agency within seven days following the occurrence of the event. This requriement was not met as evidenced by Licensee did not report the inicident that occurred on 06/12/24 to Licensing.
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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:Sergiy Pidgirny
LICENSING EVALUATOR NAME:Shawna Doucette
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


LIC809 (FAS) - (06/04)
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