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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347005181
Report Date: 05/20/2025
Date Signed: 05/20/2025 02:50:45 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2025 and conducted by Evaluator Kevin Mknelly
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20250317082226
FACILITY NAME:SAC ADP DBA AIM HIGHER-ACE PROGRAM (D1-D2)FACILITY NUMBER:
347005181
ADMINISTRATOR:DAVID, MARINAFACILITY TYPE:
775
ADDRESS:4640 ORANGE GROVETELEPHONE:
(916) 993-4191
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY:45CENSUS: 30DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Morad SheikhhoroTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility is not operating within required staff to client ratio.
INVESTIGATION FINDINGS:
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 On May 20.2025, Licensing Program Analyst (LPA) Kevin Mknelly spoke to the Assistant Director to deliver complaint findings for the above allegation.
LPA reviewed records and conducted interviews.
LPA finds that the allegations cited above are substantiated.
LPA reviewed client and staff attendance and daily logistics sheets. Records showed inconsistencies indicating days of out of ratio of 1 (one) staff per 4 (four clients).
Interviews found that staff shortages occur regularly and that daily logistics sheets at times list staff who are not present at the facility.
As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care.

Report reviewed with Morad Sheikhhoro . Copy of this report and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 59-AS-20250317082226
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SAC ADP DBA AIM HIGHER-ACE PROGRAM (D1-D2)
FACILITY NUMBER: 347005181
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/17/2025
Section Cited
CCR
82065.5(a)(1)
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82065.5 Staff-Client Ratio (a) Whenever a client who relies upon others to perform all activities of daily living is present, the following minimum staffing requirements shall be met:(1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center.
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Licensee will submit daily detailed reports, Mon-Fri. until 6/17/25 , listing the number of staff working with clients of each classroom D1- 2.
The reports will be reviewed for ratio. The POC is to be cleared based on consistent ratios as required.
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This requirement was not met based on records and interviews finding incidents of out of ratio incidents. This posed a potential risk to residents.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
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