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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601767
Report Date: 07/31/2024
Date Signed: 07/31/2024 11:40:43 AM

Document Has Been Signed on 07/31/2024 11:40 AM - 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:COLE VOCATIONAL SERVICES SIGNAL HILLFACILITY NUMBER:
198601767
ADMINISTRATOR/
DIRECTOR:		PORTER, LASONJAFACILITY TYPE:
775
ADDRESS:2798 JUNIPERO AVETELEPHONE:
(562) 912-7340
CITY:SIGNAL HILLSTATE: CAZIP CODE:
90755
CAPACITY: 30CENSUS: 30DATE:
07/31/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Aniece JohnsonTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 07/31/24, Licensing Program Analysts (LPAs) Perry Scott and Zina Brown conducted an unannounced annual required inspection to the above Adult Day Program (ADP) using the new Cares Tool. Upon arriving at the facility LPAs met with Aniece Johnson, Program Director and explained the purpose of today’s visit. The facility is licensed to serve thirty (30) Non-Ambulatory Developmentally Disabled clients, ages 18 - 59 years. There are nine (9) restricted health care conditions consumers. Staff to Client ratio is one (1) staff to three (3) clients. The facilities annual fees are current.

LPAs conducted a records review of (8) client records, (6) staff records, and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. Facility did not have any clients that required medication.

LPAs and Program Director toured the physical plant. The facility consists of the following: Activity Room, Computer Room, Art Room, Nurse Station, Style Room, Sensory Room, Changing Room, Kitchen, Storage and Administrative offices. The program hours are 8:00am to 12:00pm and from 1:00pm to 5:00 pm Monday through Friday. Clients bring their own lunches, however the facility has backup food to prepare for clients, if needed. Facility provides one snack per program session for all clients. There is a nurse on premises that gives clients medications as prescribed. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility. Care and supervision necessary to meet the client's needs and all services specified in the admission agreements are being met.

LPAs observed the facility walls/ floors were in good condition, and there is adequate lighting throughout the facility. The fire extinguishers were properly charged and last serviced on 01/26/2024. Smoke and carbon monoxide detectors are operational. The program has ample storage space. The chemicals and sharp objects were properly stored/ locked.

Report continued on LIC809-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: COLE VOCATIONAL SERVICES SIGNAL HILL
FACILITY NUMBER: 198601767
VISIT DATE: 07/31/2024
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The restrooms were clean and maintained in a safe and sanitary operating condition. The facilities kitchen is clean and well maintained. The first aid kit was stocked with a manual and available for use. The facility walkways and exits throughout the ADP were clear of hazards and accessible to clients. The hot water temperature was measured and is within Title 22 Regulations (111.6F).

The facility provides lockers to clients for their personal belongings. Facility staff ensures that clients are kept clean and dry, and that the day program facility remains free of odors. The program administration develops, maintains, and implements written plans for orientation and on-the-job training.

During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed that sanitizing stations were in common areas and restrooms. LPA observed that the facility had the required postings, posted throughout the facility. LPA further observed the facility to have a 60-day supply of Personal Protective Equipment (PPE).

LPA advised the administrator to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing (www.cdss.ca.gov) for Provider Informational Notices (PIN) and for any updates relating to COVID-19 guidance and other related issues.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPAs did not observe any deficiencies, therefore no citations were issued at this time.

Exit interview held and a copy of the report was provided to Aniece Johnson, Program Director.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
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