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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803590
Report Date: 02/27/2025
Date Signed: 02/27/2025 10:03:22 AM

Document Has Been Signed on 02/27/2025 10:03 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/
DIRECTOR:
MENDEZ, DIANAFACILITY TYPE:
775
ADDRESS:131-A STONY CIR STE 750TELEPHONE:
(707) 528-3771
CITY:SANTA ROSASTATE: CAZIP CODE:
95401
CAPACITY: 60CENSUS: 18DATE:
02/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Diana Mendez (Program Manager)TIME VISIT/
INSPECTION COMPLETED:
10:18 AM
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Licensing Program Analysts (LPAs) Cuadra and Deniz arrived unannounced to conduct a Case Management - Other Visit and met with Diana Mendez, Program Manager. The purpose of this Case Management Visit is to conduct a subsequent follow up on SOC341 report submitted to Community Care Licensing (CCL) on 12/16/24 along with an incident report.

Per SOC341, on 12/10/2024 at approximately 3:00pm, facility staff (S2) approached Police Department and reported that on 12/09/2024, at approximately 2:00pm they have witnessed another staff (S1) performing a physical restraint on participant (P1). S2 reported that S1 hugged P1 from behind and restrained their arms. On 12/11/2024, S1 was placed on a leave of absence and an investigation will be conducted to gather further information. On 12/12/24 an outside agency notified P1's responsible party including cross report sent to pertinent agencies. Police Report #SR-2414304. According to SOC341, the facility will continue to monitor and support P1 while at Day Program.



During today’s visit, LPAs previously received their results for their internal investigation conducted where it was determined that there was no substantial evidence found that S1 have performed any type of physical abuse to P1. Police report #SR-2414304 did not reveal any supporting information that a physical abuse was performed. LPA conducted interviews with staff. Based on staff statements, S1 observed P1 attempting to harm themselves by throwing their tv tray, so they put their hands around P1, which it was an old training strategy. According to S2, P1 experiences aggressive behavior towards others or their own stuff when they are not picked up on time, S1 came to help and they were observed holding P1 in a protective hold by placing their own hands around P1, which it was an old training technique that they don't longer use, but S2 clarified to LPA that S1 did not touch P1's body at any time or held participant's hands. S1 confirmed that they never touched P1 or restrained their arms. The facility have discussed the incident with P1's responsible party who have suggested to have P1 to decompress every day by leaving them alone for about five to ten minutes prior to their responsible party comes to pick them up from day program, which it has resulted in less behavioral issues exhibited by P1. No deficiencies during today's visit. Exit interview conducted with Program Manager and report was given.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2025
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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