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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701425
Report Date: 07/31/2024
Date Signed: 07/31/2024 11:16:33 AM

Document Has Been Signed on 07/31/2024 11:16 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:AIM HIGHER, INC.FACILITY NUMBER:
392701425
ADMINISTRATOR/
DIRECTOR:		WOODFORD, MAXFACILITY TYPE:
775
ADDRESS:2609 E. HAMMER LANETELEPHONE:
(916) 995-5164
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 70CENSUS: 0DATE:
07/31/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Max WoodfordTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Michael Bilger conducted a pre-licensing visit to this facility on 7-31-24 at 9:55am and was met by the Applicant Max Woodford. A brief interview was conducted with the Applicant. An approved infection control plan and disaster plan is in place for this facility.
It was learned that this facility will be licensed as an Adult Day Program to serve up to 70 clients of which 5 may be non-ambulatory. This Applicant is also seeking new licensure as a result of a change in location. There were no clients present during today's pre-licensing visit. A tour of the facility was conducted by LPA.
Common areas and other areas intended for resident use including classrooms and bathrooms were toured and observed to be adequately furnished and maintained in compliance at this time. This facility has five classrooms and two of bathrooms for client use. Additionally, facility has two offices, one conference room, and one changing room. An outside area is also designated for client use. Exit signs are in place as appropriate. Fire extinguishers are in place and fully charged. Facility map indicating emergency exits posted in appropriate locations. Interior of facility presents as clean and sanitary with no obvious stains on floors and walls. Additionally, LPA did not observe any foul odors throughout. Facility temperature was 74*F.
Kitchen area was toured and observed to be clean and sanitary. Medication storage area was observed to contain a locking mechanism. First aid kit was observed to be present and contained all required components at this time.
A tour of the facility bathrooms was conducted. Hot water temperatures were taken and measured within the allowed range of 105-120 degrees. A sufficient amount of supplies for various activity programs was observed to be in place and ready for use. Facility has a designated staff break room.
A tour of the exterior grounds was conducted. LPA observed sufficient space for safe and adequate transportation needs. No obstructions of fire exits noted. Client rights are posted in multiple locations. This facility has been found to be in compliance at this time.
There were no deficiencies observed during today's Pre-licensing visit. Exit Interview conducted with Max Woodford. A copy of this report was left with the Applicant
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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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