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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366403248
Report Date: 01/05/2024
Date Signed: 01/05/2024 11:14:39 AM

Document Has Been Signed on 01/05/2024 11:14 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 BIG BEARFACILITY NUMBER:
366403248
ADMINISTRATOR:PENDINGFACILITY TYPE:
775
ADDRESS:40627 BIG BEAR BLVDTELEPHONE:
(909) 878-2272
CITY:BIG BEAR LAKESTATE: CAZIP CODE:
92315
CAPACITY: 45CENSUS: 22DATE:
01/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:33 AM
MET WITH:Sheila Norris, Program ManagerTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility for a required annual inspection. LPA identified herself to day program manager (PM) Sheila Norris who was advised of the purpose of the visit. The facility is currently licensed as an Adult Day Program and has 10 clients present.

LPA Bueno and PM Norris toured the facility. The facility has no bodies of water. LPA and PM observed that client access doors are unlocked and free of obstruction. The facility has a working telephone for use. The facility fire extinguishers were last inspected on 10/25/23. The fire alarms are maintained and tested by a third party service provider. During today's visit, the carbon monoxide detector was installed. The last fire and earthquake drill was conducted on 11/28/23 and flood drill was completed on 10/26/23.

The following were observed of the physical plant:
LPA Bueno and PM Norris observed all activity rooms were kept clean and free from odors. Hazards were kept safe and secured from clients. Activity rooms had appropriate seating and tables for activities for all clients served. LPA and PM observed clients participating in activities while maintaining appropriate staffing within each group. LPA Bueno observed a kitchen with a refrigerator and several storage cabinets. The facility provides snacks. Restrooms were clean and toilet paper, paper towels and soap is present in each. Three bathrooms were inspected by LPA Bueno and PM Norris. A complete first aid kit was observed. The facility does not maintain any medication nor does it use manual restraints. Toxins, cleaning agents, and other supplies are kept locked and secured.

The following records were reviewed:
LPA Bueno inspected client files and found that required documentation including clients' rights, admissions agreement, and Individual Service Plan (ISP). LPA reviewed staff files were inspected which contained background clearance, First Aid/CPR certification, and required training. An exit interview was conducted where this report was discussed with provided to PM Norris at the conclusion of the inspection.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2024
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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