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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004075
Report Date: 03/01/2022
Date Signed: 03/01/2022 04:50:59 PM

Document Has Been Signed on 03/01/2022 04:50 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, 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: 50DATE:
03/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Vean Loeun, Program DirectorTIME COMPLETED:
05:00 PM
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On 3/01/22 at 3:25 pm, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. Prior to entering the facility, LPA Truong attempted to contact the facility, but the calls went to voicemail. LPA met with Program Director Vean Loeun and explained the purpose of the visit.

Administrator holds current certification #6006694735 and expires on 11/27/2023. The facility is licensed for 50 ambulatory residents of which 10 may be non-ambulatory. LPA toured the facility with Program Director Vean Loeun on 3/01/22 at 3:45 pm.

LPA inspected the physical plant including but not limited to the kitchen, classrooms, resident bathrooms, multi-purpose room, and outside area of the facility to ensure compliance with Title 22 regulations. Facility is an adult day program facility with a current census of 50. There are 2 classrooms and a multi-purpose room, all are in use at this time. This program has a 4:1 ratio. Based on staffing, the facility is within ratio requirements.

Hot water temperatures were taken to make sure that the hot water being dispensed was within the allowed range of 105-120 degrees Fahrenheit. Fire extinguishers and first aid kits were up to date. Room temperature reads 75 degrees Fahrenheit. Resident classrooms were sanitary and had the required furniture and furnishings along with social distancing practiced. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. LPA also conducted the infection control domain tool.

Report continued on 809-C
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2022
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: 03/01/2022
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The facility submitted a LIC 808 mitigation plan on 4/27/2021. The facility has central entry point and has implemented screening and sign in procedures at the front lobby area. The facility conducts routine symptom screening for employees, clients, and visitors. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility and on the front entry.

The following forms and documents were requested by this LPA to be updated and submitted into CCL:
LIC 200
LIC 308
LIC 500
LIC 610

Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
LIC809 (FAS) - (06/04)
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