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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200947
Report Date: 04/29/2024
Date Signed: 04/29/2024 12:49:26 PM

Document Has Been Signed on 04/29/2024 12:49 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:AIM HIGHFACILITY NUMBER:
079200947
ADMINISTRATOR/
DIRECTOR:		TRUCKS, CHRISTINAFACILITY TYPE:
775
ADDRESS:1336 SUNSET DRTELEPHONE:
(925) 978-9918
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 30CENSUS: 28DATE:
04/29/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Alberto Vega, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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On 4/29/2024 at 12:30pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to conduct a health and safety check as a result of the department receiving a complaint. LPA met with Alberto Vega, Administrator, and explained the reason for the visit.

Upon arrival, LPA observed some clients standing outside and some inside. Staff was taking some of the clients into the community. There were three (3) staff inside with the clients inside the facility doing activities. Facility is noted to be clean and in good repair and residents in care appear to be safe. There are no imminent health/safety concerns on today's date.

No deficiencies were cited today.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
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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