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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601783
Report Date: 10/22/2024
Date Signed: 10/22/2024 11:36:32 AM

Document Has Been Signed on 10/22/2024 11:36 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:AIM HIGHER INCFACILITY NUMBER:
198601783
ADMINISTRATOR/
DIRECTOR:		GABRIELLA BRANDFACILITY TYPE:
775
ADDRESS:1751 ROWLAND AVENUETELEPHONE:
(626) 332-2357
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY: 70CENSUS: 66DATE:
10/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:58 AM
MET WITH:Gabriella Brand - Program DirectorTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Gabriella Brand and explained the reason for the visit.

Facility is licensed to serve 70 adults over the age of 18 of which 10 adults may be non-ambulatory. Facility serves as an Adult Day Program. Facility is located in a commercial building and consist of a lobby, a conference room, exercise room, life skill room, volunteer room, outing room, media room, vocational room, changing room/relaxation room, program director office, administration office, staff break room/kitchen, two (2) female bathrooms and two (2) male bathrooms.

LPA conducted a tour with Gabriella Brand and observed the following:
Facility is in good repair indoors and doors. Each activity room was observed clean, furnish according to the activity. The break room/kitchen was observed to have a lock cabinet were the sharps are maintain. Cleaning supplies are kept lock in the conference room. A changing room was observed which is also used as an isolation area for clients. A large refrigerator was observed to store clients meals that may need refrigeration. Cooking activity area was observed clean and food preparing items were observed properly stored.
Each bathroom was observed in good repair and water temperature was tested between 104.3 - 108.1 degrees F., which is not within the required 105-120 degrees F.
The facility has a fire sprinkler system that was last checked by the fire department on 8/23/23. No large bodies of water were observed at the facility. Facility does not have an outdoor area. However, facility facilitates outings to the community either walking or in facility's vans which have the pertinent records. Drivers have current driving licenses.
LPA reviewed files for 5 clients and 5 staff. Administrator does not have a total of 30 hours of continuous education. Client #4 IPP is dated 1/27/22 and #5 IPP is dated 5/30/20.LPA interviewed 4 staff and 4 clients. Client #3's physician's report notes a TB test was done but does not show test results.
(CONTINUED ON LIC 809C)
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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Document Has Been Signed on 10/22/2024 11:36 AM - It Cannot Be Edited


Created By: Mary G Flores On 10/22/2024 at 11:12 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: AIM HIGHER INC
FACILITY NUMBER: 198601783

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82064(d)
Administrator -Qualifications and Duties
(d) The administrator shall receive and document a minimum of 30 clock hours of continuing education every 24 months of employment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation record review, the licensee did not comply with the section cited above in administrator does not have a minimun of 30 hours of continuing education within the last 24 hours which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/04/2024
Plan of Correction
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Program Director will schedule/enroll in 30 hours of education/training and submit proof to the department by POC due date.
Type B
Section Cited
CCR
82068.2(d)(1)
Needs and Services Plan
(d) If the client has an existing needs appraisal or individual program plan (IPP) completed by a placement agency, or a consultant for the placement agency, the Department may consider the plan to meet the requirements of this section provided that: (1) The needs appraisal or IPP is not more than one year old.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation record review, the licensee did not comply with the section cited above in 2 out of 5 clients, IPPs are older than one year which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/29/2024
Plan of Correction
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Program Director will obtain IPPs for client #4 and #5 and will submit a copy to the department by POC due date 10/29/24.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tony Vasallo
LICENSING EVALUATOR NAME:Mary G Flores
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2024


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: AIM HIGHER INC
FACILITY NUMBER: 198601783
VISIT DATE: 10/22/2024
NARRATIVE
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LPA reviewed Infection Control Plan and Emergency Disaster Plan LIC 610D (10/03) which does not meet the criteria for the current version LIC 610D(12/21).

Deficiencies were noted on LIC 809D per Title 22 regulations.

Exit interview was conducted with Gabriella Brand and a copy of this report, LIC 809D, and appeal rights were provided.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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