<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800122
Report Date: 03/08/2022
Date Signed: 03/08/2022 12:02:55 PM

Document Has Been Signed on 03/08/2022 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:COLE VOCATIONAL SERVICES CUCAMONGAFACILITY NUMBER:
361800122
ADMINISTRATOR:CAMPOS, CHRISTINEFACILITY TYPE:
775
ADDRESS:1810 E ELMA CTTELEPHONE:
(909) 390-3204
CITY:ONTARIOSTATE: CAZIP CODE:
91764
CAPACITY: 75CENSUS: 8DATE:
03/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Christine Campos- Day Program ManagerTIME COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Ryan Gardner and Licensing Program Manager (LPM) Karen Clemons made an unannounced visit to the day program to conduct an annual inspection focused on infection control. LPA was greeted and granted entry by Day Program Manager Christine Campos. LPA explained the purpose of the visit. At the time of visit there were 14 staff, and 6 participants present. The day program currently has no positive or suspected Covid-19 cases. The day program opened back up for on site services in February 2022.

During today's visit, LPA toured the day program and made observations regarding the infection control measures that the day program has implemented. The day program has an adequate amount of hand hygiene supplies (soap, hand sanitizer). All staff present were also observed wearing appropriate face coverings. The staff clean and disinfect multiple times a day with EPA approved cleaners.

The day program has a plan in place to monitor participants regularly for any changes in condition, which includes daily temperature checks upon entry and screening questions. Should a consumer begin to exhibit any symptoms related to COVID-19, day program staff will contact the client's responsible party. The consumer will wait in the designated isolation room located near the front entry until they are able to be picked up from the day program.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and a copy of this report was provided to Christine Campos.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Ryan Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1