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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602021
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:29:47 PM

Document Has Been Signed on 10/30/2024 03:29 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:COLE VOCATIONAL SERVICES BIXBY KNOLLSFACILITY NUMBER:
198602021
ADMINISTRATOR/
DIRECTOR:		APRIL STEPHENSFACILITY TYPE:
775
ADDRESS:4343 ATLANTIC AVETELEPHONE:
(562) 490-0263
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 30CENSUS: 22DATE:
10/30/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:03 AM
MET WITH:April Stephens, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On October 30, 2024 Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator April Stephens, and the purpose of today’s visit was explained. LPA was granted access to the facility. The facility is licensed to serve 30 developmentally disabled adults ages 18 and over.
Facility Structure:
The facility is a single-story commercial structure located in a residential neighborhood. It consists of the following: four (4) bathrooms, a garden room, art room, style room, computer room, relaxation room, game room, exercise room, kitchen, laundry room, and staff and nurse offices.

LPA and Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected and are in good condition and well maintained. LPA observed sufficient lighting was provided to clients and staff. Storage for client’s personal belongings was observed. Walls and floors were in good repair.

LPA observed the facility to be clean and properly furnished at the time of the visit. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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 BIXBY KNOLLS
FACILITY NUMBER: 198602021
VISIT DATE: 10/30/2024
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Safety

The facility is equipped with smoke and carbon monoxide detectors that are operable. The last inspection of fire alarm system was on 10/30/24. LPA observed 2 fully charged fire extinguishers last serviced on 8/1/24. Last emergency drill was conducted on 10/14/24. All entrance/exit doors are marked and accessible. The bathrooms were found to be within Title 22 regulation and were clean and operational. Water temperature properly measured at 110.1 degrees F in bathroom #1,109 degrees F in bathroom #2, 106 F in bathroom #3, and 110 F in bathroom #4. The water temperature in the kitchen measured at 109.8 degree F. LPA observed a comfortable temperature was maintained in the facility.

Infection Control

During visit, LPAs observed the facilities Infection Control procedures. At the entrance is a sign-in log and a hand sanitizing station. LPA observed Infection Control signs posted throughout the facility.

Files/Postings

LPA reviewed three (4) staff files and found that ( 4) out of (4 ) contain the required documents, certification, and training. LPA reviewed (4) client files and found that ( 4 ) out of (4 ) contained the required documents. LPA observed all required posting including license, personal rights, “see something, say something,” activity schedule, snack menu, infection control signs. During file review, LPA observed all licensing fees are current.

No deficiencies were cited during inspection. LPA conducted final interview with Administrator, April Stephens , and a copy of this report was provided.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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