366403248-4-28-2023-56-AS-PGUO-CRBP29-20230428105535

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 366403248
Report Date: 04/28/2023
Date Signed: 04/28/2023 10:56:40 AM

Document Has Been Signed on 04/28/2023 10:56 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 BIG BEAR		FACILITY NUMBER:	366403248
ADMINISTRATOR:	PENDING		FACILITY TYPE:	775
ADDRESS:	40627 BIG BEAR BLVD		TELEPHONE:	(909) 878-2272
CITY:	BIG BEAR LAKE	STATE: CA	ZIP CODE:	92315
CAPACITY: 45		CENSUS: 21	DATE:	04/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sheila Norris		TIME COMPLETED:	11:13 AM

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Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Administrator Sheila Norris and was granted entry to the facility. At the time of the visit there was two (2) staff present, and no clients were attending Day Program at the time of the visit. The facility is Day Program with one (1) isolation room tree (3), restrooms, with kitchen, and six (6) activity rooms for clients. The facility is an Adult Day Program (ADP) level 2 designated program vendorized by Inland Regional Center. Licensed capacity is (45) current census (21). LPA was accompanied by Facility Administrator Sheila Norris to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client activity rooms; they are equipped with required furniture and activity supplies for clients; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The hot water temperature tested within regulation at 110.11 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated storage space for client/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for clients.

Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a variety of food available for clients. Dishes, cups, and utensils were also stored properly.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: COLE VOCATIONAL SERVICES BIG BEAR	FACILITY NUMBER: 366403248
	VISIT DATE: 04/28/2023

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Care & Supervision: Facility has sufficient care staff for coverage. All staff members working in the facility have criminal record clearance through the department.

Record Review: LPA reviewed six (6) client files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings.

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 this report (LIC809) was discussed and provided to Facility Administrator Sheila Norris.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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