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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004075
Report Date: 01/02/2024
Date Signed: 01/02/2024 02:08:15 PM

Document Has Been Signed on 01/02/2024 02:08 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:AIM HIGHER INC.FACILITY NUMBER:
347004075
ADMINISTRATOR:VEAN LOEUNFACILITY TYPE:
775
ADDRESS:3151 DWIGHT ROAD, SUITE 100TELEPHONE:
(916) 391-4668
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 50CENSUS: 32DATE:
01/02/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Vean LoeunTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with program director Vean Loeun and explained the purpose of the visit.

LPA Moleski reviewed 10 client files (C1-C10) and 10 staff files (S1-S10).

LPA Moleski toured the facility with Loeun and inspected common areas, and bathrooms. The facility's temperature was 71 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 112 degrees Fahrenheit, which is within the required range of 105 and 120 degrees.

LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and carbon monoxide/smoke detectors. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed a locked cabinet for the storage of cleaning solutions.

LPA Moleski interviewed three staff members (S6, S7, S10) and four clients (C10-C13).

No deficiencies were cited during this visit. An exit interview was conducted and a copy of this report was left with Loeun.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2024
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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