565800303-4-17-2025-29-AS-KLOZ-DG8UP2-20250430154449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800303
Report Date: 04/17/2025
Date Signed: 04/17/2025 01:58:36 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/15/2025 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20250415140923

FACILITY NAME:	COLE VOCATIONAL SERVICES AUTO CENTER		FACILITY NUMBER:	565800303
ADMINISTRATOR:	LISA LOPEZ		FACILITY TYPE:	775
ADDRESS:	2011 AUTO CENTER DR STES 106-7		TELEPHONE:	(805) 278-2700
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY:	60	CENSUS: 49	DATE:	04/17/2025
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	supervisor Jinica Destrampe		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not meet the needs of a client while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Esther Cortez conducted an initial 10-day complaint visit at the Day Program (DP) regarding the above allegation. The LPA met with the Day Program's supervisor Jinica Destrampe and explained the reason for the visit.

During today's visit the LPA briefly toured the DP, observed residents eating lunch, attempted to interview Client #1 (C1) and interviewed one staff (1) .

Regarding the allegation, "Staff did not meet the needs of a client while in care" it is the concern of the reporting party that on 2/21/25, Client #1 was left unchanged with a soiled diaper and this resulted in a rash severe enough to cause bleeding. File review and interview with the DP's Supervisor confirmed that the alleged incident is the same incident that was self reported on 02/21/25 by the DP via an Unusual Incident/Injury Report (LIC624). Report will continue on LIC9099-C, 2nd page.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250415140923

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: COLE VOCATIONAL SERVICES AUTO CENTER	FACILITY NUMBER: 565800303
	VISIT DATE: 04/17/2025

NARRATIVE

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On 02/21/2025, it was reported that Client 1 (C1) was picked up early at 11:30 a.m. due to having a terrible cough. When C1 got picked up, their family member realized they needed changing and went back inside to change the client. DP's Supervisor assisted in changing C1. Family member mentioned to Supervisor that C1's skin is easily irritated and both of them observed a small irritated spot on C1. C1's Staff (S1) for that day was informed C1 needed to be changed, and S1 apologized for their oversight.

On 02/26/25, LPA Cortez conducted a case management visit regarding the self reported incident. During the visit the LPA conducted (2) staff interviews and a file review. Interview with the DP's supervisor revealed that S1 was not a regular staff, did not read C1's file and therefore was not aware that C1 needed to be changed as part of their care needs. Furthermore, C1 went from 8:30 a.m. to 11:30 a.m. on 02/21/25 without being changed. File review conducted on 2/26/25, revealed that C1 needs to be toileted when they get to the DP, after lunch and before they get on the bus and that they have very sensitive skin and will break out in a rash if they are not changed properly.

During today's visit the DP's Supervisor revealed that only they and C1's family member where in the changing room changing C1 on 02/21/25, they did not observed any bleeding but C1 was absolutely irritated. Based on the information obtained, the Department has sufficient evidence to support the allegation, therefore the allegation Staff did not meet the needs of a client while in care, is Substantiated at this time.

Per the California Code of Regulations, Title 22, deficiency was cited during prior case management visit conducted on 02/26/2025 regarding same incident . Another deficiency will not be issued at this time. Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

LIC9099 (FAS) - (06/04)

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