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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803590
Report Date: 05/31/2022
Date Signed: 05/31/2022 10:41:21 AM

Document Has Been Signed on 05/31/2022 10:41 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:COLE VOCATIONAL SERVICES SANTA ROSAFACILITY NUMBER:
496803590
ADMINISTRATOR:CHARLTON, HOLLYFACILITY TYPE:
775
ADDRESS:131-A STONY CIR STE 750TELEPHONE:
(707) 528-3771
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 60CENSUS: 0DATE:
05/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Holly Charlton (Administrator)TIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Cuadra arrived to conduct a Case Management inspection is intended to observe precautions taken by the day program services and review re-entry plan for in-person classes and met with Administrator, Holly Charlton. Facility is currently providing alternative services to 26 participants through online activities and staff drop off activity packages including arts and crafts supplies for participants in average once a week. LPA arrived at the facility and had their temperature checked and logged. Facility has a centralized sign-in sheet located at loading area where facility documents staff, visitors and participants daily screening.

Day program will be open to in-person services to 23 participants total effective June 1, 2022 Monday through Friday. The Day program has divided participants attendance in two sets: 13 participants will come between 8:30am to 11:30am then the Day Program will take half hour to clean and disinfect the facility to receive another set of 10 participants between 12:00pm to 3:00pm. The facility has assigned two participants per table and staff including a changing room for participants to use. LPA/Administrator toured the facility, Day Program consists of a large area that ensures social distancing between staff and participants. There are sufficient personal protective equipment and incontinence care supplies. All staff are completely vaccinated and boosted. Staff was observed wearing a mask while in the facility. Staff have received required training on infection control and had been N95 fit tested. Regular maintenance plan includes sanitize every three hours or as needed. Daily cleaning log includes activity areas and entrances, bathrooms, changing rooms, kitchen and nurse's office. Facility has automated dispensers to dispense hand sanitizer. Facility has posters that are posted encouraging participants to wear a mask and maintain social distancing. The facility currently does not provide transportation services, the transportation services are provided by R&D and different vendors which will ensure to follow all the precautions, facility will also screen participants at the entrance and If a participant is exhibiting symptoms, they are to stay home and the facility has a quarantine room located at facility loading area for participants that exhibit symptoms during the day. Facility has submitted their Mitigation Plan and it was approved as of 4/13/21. No deficiencies were cited during today's inspection.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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