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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317003286
Report Date: 10/15/2024
Date Signed: 10/15/2024 11:43:48 AM

Document Has Been Signed on 10/15/2024 11:43 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:AIM HIGHER INC. DBA ED DAVIDFACILITY NUMBER:
317003286
ADMINISTRATOR/
DIRECTOR:		DAVID, EDFACILITY TYPE:
775
ADDRESS:1132 SMITH LANETELEPHONE:
(916) 783-4688
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 136CENSUS: 76DATE:
10/15/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Cheyenne SandowTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On October 15, 2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a collateral visit regarding an incident report LPA received. LPA met with Interim Administrator, and explained the purpose of the visit.

During today's visit, LPA conducted an interview with Interim Administrator and Receptionist. LPA obtained a copy of attendance sheet of September 30, 2024 and P1's case notes.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Exit Interview conducted and a copy of the report was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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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