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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366427604
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:26:33 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/08/2022 and conducted by Evaluator Rayshaun Nickolas
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20220908145243
FACILITY NAME:COLE VOCATIONAL SERVICES HESPERIAFACILITY NUMBER:
366427604
ADMINISTRATOR:HIRES, SIMIENFACILITY TYPE:
775
ADDRESS:15075 MAIN STTELEPHONE:
(760) 998-2829
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:75CENSUS: 44DATE:
01/12/2023
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Simien Hires, Program DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Personal rights
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rayshaun Nickolas made an unannounced visit to the facility to deliver the finding on the above allegation. LPA met with facility staff and was informed that the Program Director just left and will return in 10 to 15 minutes. Program Director Simien Hires arrived at the facility 20 minutes later and LPA explained the purpose of the visit.

The investigation consisted of a file review and interviews with relevant parties. The allegation alleges that on September 6, 2022, the program director received a phone call from an outside party reporting abuse of client #1 (C1). The outside party alleged that two (2) of the day program staff members abused C1, and C1 returned home from the day program with a bloody and swollen lip. All witnesses interviewed denied the allegation that staff hit C1 and denied that C1 had a bloody and swollen lip. Investigation into this incident revealed insufficient evidence to corroborate the alleged allegation. LPA made three (3) attempts to interview C1 but was unsuccessful.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Rayshaun Nickolas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 56-AS-20220908145243
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 HESPERIA
FACILITY NUMBER: 366427604
VISIT DATE: 01/12/2023
NARRATIVE
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Based on the investigation, the above finding is Unsubstantiated. A finding of unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Rayshaun Nickolas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2