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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601767
Report Date: 07/06/2023
Date Signed: 07/06/2023 03:19:11 PM

Document Has Been Signed on 07/06/2023 03:19 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:COLE VOCATIONAL SERVICES SIGNAL HILLFACILITY NUMBER:
198601767
ADMINISTRATOR:PORTER, LASONJAFACILITY TYPE:
775
ADDRESS:2798 JUNIPERO AVETELEPHONE:
(562) 912-7340
CITY:SIGNAL HILLSTATE: CAZIP CODE:
90755
CAPACITY: 30CENSUS: 61DATE:
07/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:17 AM
MET WITH:Director Aniece J. JohnsonTIME COMPLETED:
03:15 PM
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On 07/06/23 Licensing Program Analysts (LPA) Lizeth Villegas made an unannounced visit to the Cole Vocational Services Signal Hill and met with Director Aniece J. Johnson as the purpose of today's visit was explained. The facility profile shows that the facility is licensed to serve 30 non-ambulatory developmentally disabled adults, program hours are from 8:00 AM- 12:00 PM and from 1:00 PM to 5:00 PM. Cole Vocational Services Signal Hill does not provide transportation. Consumers are linked to the Harbor Regional center, the staff to consumer ratio is 1 one staff to 3 three consumers.

As a part of today's inspection LPA reviewed 6 consumer records, 2 staff records and inspected the physical plant. This is a day program located in one large building consisting of the following: Activity/game Room, Computer Room, Art Room, style Room, Nurse Station, Sensory Room, Changing Room, Kitchen, Storage/lockers and administrative offices. There is a LVN on premises that gives clients medications as prescribed. LPA observed sufficient furniture and lighting throughout the facility, walls and floors were in good condition, walkways throughout the day program and all exits were clear of hazards and debris. The facilities kitchen appears to be clean and well maintained, consumers bring their own meals and program provides snacks only.

Program Director stated there are sixteen (16) restricted health care conditions consumers, twelve (12) consumers use a G-tube and four (4) do not, restricted health care plans are in consumers files. The last disaster drill was conducted 06/20/23 and a Disaster Plan was on file. The last inspection held by the fire department was on 12/2022, two (2) Fire extinguishers were properly charged, and the first aid kit was available and fully stocked.

During today’s visit no discrepancies were observed. Exit interview conducted with Director Aniece J. Johnson and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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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