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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004075
Report Date: 07/02/2021
Date Signed: 11/01/2021 09:42:51 AM

Document Has Been Signed on 11/01/2021 09:42 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:AIM HIGHER INC.FACILITY NUMBER:
347004075
ADMINISTRATOR:DAVID, EDFACILITY TYPE:
775
ADDRESS:3151 DWIGHT ROAD, SUITE 100TELEPHONE:
(916) 599-5200
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 50CENSUS: 30DATE:
07/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Vean LeounTIME COMPLETED:
01:45 PM
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 Licensing Program Analysts (LPA)s Tirzah Hubbard and Christina Valerio conducted an unannounced annual visit. LPAs met with Administrator Vean Leoun to discuss the reason for visit. LPAs observed both programs are integrated in activities and events. Staff fingerprints checked for both programs.
Census:30

LPA observed plenty of staff during todays visit. LPAs observed day activities going on for movie day and virtual activities. LPAs learned the day program official opening day was on 7-1-21, due to Covid-19 precautionary measures.

LPAs observed that clients bring their lunches from home. Cold water and snacks are provided daily. LPAs observed all refrigerators were clean and in compliance. LPAs observed 5 fire extinguishers in compliance and up to date. All exits are clear in the day program.

Water temperature: 109 degrees.
Thermostat Temperature: 75.

LPAs observed no medication stored or given out at the day program.

Continued on C page.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Tirzah Hubbard
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: AIM HIGHER INC.
FACILITY NUMBER: 347004075
VISIT DATE: 07/02/2021
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Upon a file review the following items were discussed to be submitted with any changes annually:
Licensing fees
Criminal Record Clearances LIC536
Administrative Organization LIC309
Designation of Administrative Responsibility LIC308
Personnel Report LIC500
Qualifications of Administrator/Facility Manager- Administrator certificate
Emergency Disaster Plan LIC610D
In-service Training Program
First aid/CPR certificates

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, there are no deficiencies being cited at this time.Exit interview held and a copy of report was given.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Tirzah Hubbard
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021
LIC809 (FAS) - (06/04)
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