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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208810
Report Date: 09/29/2022
Date Signed: 09/29/2022 02:30:42 PM

Document Has Been Signed on 09/29/2022 02:30 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 BAKERSFIELD 2FACILITY NUMBER:
157208810
ADMINISTRATOR:MADKINS, JEANETTEFACILITY TYPE:
775
ADDRESS:5101 MING AVETELEPHONE:
(661) 834-8700
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 75CENSUS: DATE:
09/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Jeannette Madkins, Administrator
Hahn Mireles, Area Director		TIME COMPLETED:
02:55 PM
NARRATIVE
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On 9/29/22 at 8:35 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection at reception desk and met with Administrator Jeanette Madkins. Area Director Hahn Mireles arrived later in the inspection.

Facility uses one main entry point where screenings are conducted on all staff, clients, and visitors. Facility was observed clean and without any obstructions. Hand sanitizer was readily available to residents and visitors. Social distancing and masking is maintained in the common areas. Cleaning and PPE supplies were checked. Resident emergency contact information is updated annually or semi-annually during client meetings with Kern Regional Center and care provider. The following forms are to be submitted to CCL within 2 weeks: LIC500 and LIC610D (new revision).

The following deficiencies were observed:

1. Two fire extinguishers were observed last serviced on 9/14/21.


2. Three staff were identified without a transfer of a criminal record clearance. S1 has been working since 11/2017, S2 has been working since 6/27/22, and S3 has been working since 7/18/22.
3. S4 did not have a completed criminal record clearance and has been working in the facility since 7/25/22.

Deficiencies are being cited based on LPA observation, interview conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. Civil penalties are being assessed in the amount of $100 per day, for a maximum of 5 days for each staff, for a total of $2000. See both LIC421BG for more details.

Exit interview conducted and Plan of Correction developed and reviewed with Administrator. A copy of this report and appeal rights were given to Administrator Jeanette Madkins, whose signature confirms receipt of this report.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022
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 09/29/2022 02:30 PM - It Cannot Be Edited


Created By: Malia Thao On 09/29/2022 at 12:14 PM
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 2
FACILITY NUMBER: 157208810

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82020
Fire Clearance
All day programs shall secure through the licensing agency and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Two fire extinguishers were observed last serviced on 9/14/21, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/30/2022
Plan of Correction
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Licensee will submit proof of service for both fire extinguishers to CCL by POC due date.
Type A
Section Cited
CCR
82019(e)(2)
Criminal Record Clearance
(e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (2) Request the licensee or applicant for a license to request a transfer of a criminal record clearance as specified in Section 82019(f); or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Three staff were identified without a transfer of a criminal record clearance. S1 has been working since 11/2017, S2 has been working since 6/27/22, and S3 has been working since 7/18/22, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2022
Plan of Correction
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Licensee submitted a copy of LIC9182, LIC508, and ID for S1, S2, and S3 to LPA. LPA associated S1, S2, and S3 to the facility via Guardian website. POC cleared during inspection.
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:Malia Thao
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/29/2022 02:30 PM - It Cannot Be Edited


Created By: Malia Thao On 09/29/2022 at 12:27 PM
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 2
FACILITY NUMBER: 157208810

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82019(e)(1)
82019 Criminal Record Clearance
(e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (1) Obtain a California clearance...

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above. S4 did not have a completed criminal record clearance and has been working in the facility since 7/25/22, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/30/2022
Plan of Correction
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Licensee will provide a written statement that S4 will not return to work until the facility is able to confirm criminal record clearance with CCL, to CCL by POC due date.
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:Malia Thao
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2022


LIC809 (FAS) - (06/04)
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