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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601400
Report Date: 10/27/2023
Date Signed: 11/15/2023 12:02:54 PM

Document Has Been Signed on 11/15/2023 12:02 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:COLE VOCATIONAL SERVICES NORWALKFACILITY NUMBER:
198601400
ADMINISTRATOR:JASKA, SHERRYFACILITY TYPE:
775
ADDRESS:14028 & 14030 PIONEER BLVDTELEPHONE:
(562) 868-3444
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 15CENSUS: 15DATE:
10/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Sherry BibawyTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced required 1 year visit and met with Administrator Sherry Bibawy and April Stephens to discuss the purpose for todays visit. There are 55 client enrolled in the program and the program is allowed 15 clients to be housed inside of the building per session. There is a morning session 8/8:30-12/12:30pm and an afternoon session 12/12:30-4/4:30pm. This program has a staff to client ratio of 1:3. All clients in the day program receive case management services provided by Harbor Regional Center.

The facility is in a shopping strip mall/ business setting and consists of the following: Rest/Isolation Room, 3 administrative offices, 2 All Gender bathrooms, Game room/Recreation, Computer room, Art room, fitness room, Resource room, Staff/ Client Locker area, and fully equipped kitchen.

LPA Wesley reviewed 3 staff files and 6 client files. Fully functioning smoke /carbon monoxide detectors were tested and operational. Fully charged fire extinguishers and located throughout the facility. LPA Wesley observed locked area for toxins, sharp objects. The facility is not currently assisting with client medication. The facility passageways and doors are not blocked or obstructed, and no large bodies of water were observed. Water temperature was tested and measured between 8888888888888 degrees Fahrenheit. Bathrooms contained a single stall for all genders. LPA Wesley toured the kitchen and observed the pantry, stoves, and refrigerator. The facility is only responsible for providing snack. Buildings and grounds free from hazards. Last emergency drill was conducted on 09/28/23 . LPA receive a copy of the infection control plan.
There were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided April Stephens.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Nicol Wesley
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2023
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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