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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880780
Report Date: 11/29/2023
Date Signed: 11/29/2023 11:45:03 AM

Document Has Been Signed on 11/29/2023 11:45 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:COLE VOCATIONAL SERVICES - CHINOFACILITY NUMBER:
361880780
ADMINISTRATOR:GIMM, DONNAFACILITY TYPE:
775
ADDRESS:13110 & 13124 9TH STTELEPHONE:
(909) 483-2505
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 30CENSUS: 12DATE:
11/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Diyoe Harckum, Program Manager TIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA), Javier Prieto made an unannounced visit to Cole Vocational Services in Chino CA.. The purpose of today’s visit was to conduct the Annual Inspection. LPA was greeted by Emily Wilcoxand allowed to enter the facility to conduct the inspection.

On today’s visit the walk through was conducted with Diyoe Harckum, Program Manger.

Walk Through: Licensee is not operating beyond the conditions and limitation specified on the license. The staff/client ratio at this Adult Day Program today was 1 to 3. There are no pools or other bodies of water located on the premises. All fire extinguishers were fully stocked and not due for another inspection until September 2025. A comfortable temperature was being maintained in the facility. Hot water temperature was tested in a couple of public restrooms. Water temperature measured at 107. degrees Fahrenheit. All toilets, hand washing, and bathing facilities are safe, sanitary, and in good operating condition. Facility has one or more functioning carbon monoxide and smoke detectors that are in operating condition. The last fire and disaster drill was conducted on 10/31/2023.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 - CHINO
FACILITY NUMBER: 361880780
VISIT DATE: 11/29/2023
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Lighting in facility worked properly. The facility had a well stocked First Aid kit and had a First Aid manual on hand. Kitchen area was observed for loose sharps, cleaning supplies and poisons. Overall, the facility was in good condition.

Records: LPAs reviewed staff records for criminal record clearance, first aid/CPR and CPI training. Client records were reviewed for updated needs and services plans (IPP).

Based on observations, no deficiencies will be cited per Title 22, California Code of Regulations. An exit interview was conducted and a report of this inspection was left with the Program Manager of the facility.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
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