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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366402294
Report Date: 08/23/2023
Date Signed: 08/23/2023 11:20:12 AM

Document Has Been Signed on 08/23/2023 11:20 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:COLE VOCATIONAL SERVICES VICTORVILLEFACILITY NUMBER:
366402294
ADMINISTRATOR:COX, BRANDONFACILITY TYPE:
775
ADDRESS:16519 VICTOR STTELEPHONE:
(760) 962-9111
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 120CENSUS: 94DATE:
08/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:04 AM
MET WITH:Erin Bomgaars- Program ManagerTIME COMPLETED:
11:24 AM
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Licensing Program Analyst (LPA) Michelle Echeverrria conducted an unannounced case management visit to follow up on an incident report sent to licensing dated on 07/21/23. The incident involved a staff (S1) who was under the influence of alcohol while supervising (C1) and (C2). LPA was greeted and explained the reason for the visit to Program Manager, Erin Bomgaars.

During today's visit, it was discovered that the facility obtained evidence that confirmed (S1) allegations of being under the influence of alcohol. (S1) was placed on an unpaid administrative leave effective 07/20/23 and terminated on 08/09/23. Refresh training on supervision and driving was given to staff on 08/03/23 and 08/17/23.

No deficiencies were observed during this visit. An exit interview was conducted where this report was, reviewed, discussed and then provided to Program Manager, Erin Bomgaars.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Michelle Echeverria
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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