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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200947
Report Date: 09/25/2024
Date Signed: 09/25/2024 01:55:51 PM

Document Has Been Signed on 09/25/2024 01:55 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: 23DATE:
09/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Alberto Vega, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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On 9/25/2024 at 1:00pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to conduct a case management visit. LPA met with Alberto Vega, Program Manager, and explained the reason for the visit.

LPA had received information during an annual visit to a facility that the facilities are now required to transport the client(s) to the day program. The facilities were given a letter dated 4/30/2024 informing them that the day program vans were out-of-service. On today's date LPA spoke with S1 and was advised the day program has one (1) working van and the clients are still being taken into the community on outings. S1 stated the day program rotates who goes out. The day program only transports a few of the clients that live close to the facility back and forth daily. S1 stated the day program keeps a log for each client and what activity they do each day.

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: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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