198602149-9-1-2022-11-AS-PSCT-CHUPPB-20220901112916

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602149
Report Date: 09/01/2022
Date Signed: 09/01/2022 11:29:24 AM

Document Has Been Signed on 09/01/2022 11:29 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	COLE VOCATIONAL SERVICES SAN PEDRO		FACILITY NUMBER:	198602149
ADMINISTRATOR:	TOTTEN, KIMBERLY		FACILITY TYPE:	775
ADDRESS:	407 N HARBOR BLVD		TELEPHONE:	(909) 483-2505
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY:	30	CENSUS: 2	DATE:	09/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Tanisha Stewart		TIME COMPLETED:	11:40 AM

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Licensing Program Analyst Perry Scott made an unannounced visit to Cole Vocational Services San Pedro (ADP) located in San Pedro, Ca. The purpose of today's visit was to conduct an annual inspection, with a primary focus on Infection Control measures using the new CARE Inspection Tool. On today's visit LPA met with facility Program Manager, Tanisha Stewart. LPA was properly screened for Covid-19 symptoms and temperature was checked and logged.

The facility is licensed for a capacity of 30 ambulatory and non-ambulatory clients. During todays visit two (2) clients were in the building. The program manager stated that the facility has 25 enrolled in the program and two (2) were present during today’s visit and are ambulatory; everyone else is virtual. Program Manager stated none of the clients have restricted health care conditions or utilize any protective devices. The last disaster drill was conducted 8/24/2022 and a Disaster Plan was on file; and all fire extinguishers were charged and last serviced on 03/01/22.

As part of the inspection, my primary focus was on infection control. LPA observed the facility’s infection control practices: LPA observed a sanitizing station at the facility entrance. PPE supplies are readily available to staff, and additional supplies are stored. Sufficient paper, cleaning, and disinfecting supplies were observed. Logs are kept indicating the times when cleaning and sanitizing is completed.

Report continued form LIC 809-C.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: COLE VOCATIONAL SERVICES SAN PEDRO	FACILITY NUMBER: 198602149
	VISIT DATE: 09/01/2022

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This is a day program located in a one-story large building and consists of the following: Parking lot (drop off/pick up area), lobby area, there is a game area, style room, garden room, computer room, art room and relaxation room. Additionally, there is a kitchen, pantry, and storage area. The storage area is locked and inaccessible to clients with cleaning supplies. There are several offices, four bathrooms (men’s, women's, unisex), and a small outside area. Facility walls and floors were in good condition, adequate lighting, and knives are locked in Program managers office in cabinet. The phones are operational, smoke alarms are hardwired, and Client and staff files are to be kept in Program managers office.

The Adult Day Program is in a commercial business building located in a residential neighborhood, operating hours are 8:00 A.M. to 4:30 P.M., clients are at the day program from 8:30 A.M. to 12:30 P.M.; 2 days a week Wednesday and Thursday. All clients bring their own lunch, if clients forget their lunch the day program will provide a snack for clients.

Documents are posted as mandated. The following Title 22 regulated areas were audited and found to be complying: Hot water temperature measured at 116.1 degrees Fahrenheit, smoke and carbon monoxide detectors are operational and in compliance, restrooms are clean and operational, toxic/sharp items are locked and inaccessible to clients. The first aid kit is fully stocked with a manual. The day program grounds are free of debris/hazards.

There were no deficiencies cited at this time.

Exit interview conducted and a copy of the Facility Evaluation Report will be given to Program Manager, Tanisha Stewart.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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