<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366427604
Report Date: 09/18/2024
Date Signed: 09/18/2024 12:44:39 PM

Document Has Been Signed on 09/18/2024 12:44 PM - 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 HESPERIAFACILITY NUMBER:
366427604
ADMINISTRATOR/
DIRECTOR:
HIRES, SIMIENFACILITY TYPE:
775
ADDRESS:15075 MAIN STTELEPHONE:
(760) 998-2829
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 75CENSUS: 59DATE:
09/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Simien HiresTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Program Director, Simien Hires and discussed the purpose of the visit. The facility is an Adult Day Program (ADP) with a license capacity of (75) and a current census (59). LPA conducted an overall inspection, which included, but was not limited to, the following:

Operation/Physical Plant: The facility was observed to have sufficient care staff to assist clients at program. Facility passageways were kept free of obstruction. Activity areas were maintained clean and odor free. The facility has sufficient activity space and supplies. The facility is maintained at a comfortable temperature of 72 degrees F. Client bathrooms were maintained clean and odor free. The hot water temperature tested at 118 degrees F. The facility is equipped with smoke/carbon monoxide alarms, fire extinguishers and telephone service. Cleaning supplies, disinfectants and other dangerous items were kept locked.

Food Service: Facility kitchen area was maintained clean. Clients bring their own lunch. Program provides snacks to clients. The facility has a sufficient supply of bottled water for clients.

Record Review: The facility has an infection control plan, emergency disaster plan, and client registry on file. five (5) staff records reviewed had First Aid/CPR certifications, criminal record clearances, job training, and health screenings. five (5) client records reviewed had admissions agreements, needs and service plans, and medical assessments.

Based on observations and record review, a technical advisory was issued and no deficiencies were cited during today’s visit. An exit interview was conducted where this report was discussed and copy of this report was provided to the Program Director at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2