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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701425
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:46:23 PM

Document Has Been Signed on 10/30/2024 03:46 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:
392701425
ADMINISTRATOR/
DIRECTOR:
WOODFORD, MAXFACILITY TYPE:
775
ADDRESS:2609 E. HAMMER LANETELEPHONE:
(916) 995-5164
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 70CENSUS: 63DATE:
10/30/2024
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Tanya MongeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 10-30-2024 at 12:55pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct a post licensing inspection visit. LPA met with the Program Director Tanya Monge and explained the purpose of the visit.

LPA inspected the physical plant including but not limited to the kitchen area,client classrooms; client bathrooms, common areas, and outside of the facility to ensure compliance with Title 22 regulations. Facility is an adult day program with a current census of 63 . Facility has 5 classrooms, and 2 bathrooms for client use.. Facility has a kichen area and changing room available for clients. LPA also conducted the inspection using the CARE tool. The facility has an approved infection control plan in place.

Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 71*F. Client classrooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 5-21-24. All toxins and other dangerous items including sharp objects were locked and inaccessible to clients in care. Medication storage area was observed to be locked and inaccessible to clients in care. First aid kit was observed to be locked and accessible to staff only.

During this inspection 5 client files and 5 staffing files were reviewed for regulatory compliance. All files contained required contents including staff training requirements. Client files contained all appropriate contents including updated admission agreements, medical assessments, and updated appraisal forms as required. {Cont. on 809C}
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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
VISIT DATE: 10/30/2024
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Facility does not contain any bodies of water. LPA observed personal rights information posted. Facility has appropriate internet access available for resident use. LPA observed facility’s sufficient equipment and supplies to meet activity program needs of residents in care. LPA reviewed facility’s disaster plan to ensure regulatory compliance. Facility conducts quarterly fire drills. LPA requested an updated copy of LIC 308 and LIC 500.

Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Program Director Tanya Monge
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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