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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208810
Report Date: 11/09/2023
Date Signed: 11/09/2023 01:59:05 PM

Document Has Been Signed on 11/09/2023 01:59 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: 59DATE:
11/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Administrator, Jaenette MadkinsTIME COMPLETED:
10:33 AM
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Licensing Program Analyst (LPA) Darius Williams conducted a Case Management visit in response to a report that was provided to the Department from the facility. LPA met with Administrator, Jaenette Madkins and discussed the purpose of the visit.

LPA met with Quality Improvement Specialst and discussed the incident. Currently, it is still being investigated.

LPA met with Resident 1 and toured facility.

At this time further investigation is required.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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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