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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202216
Report Date: 12/06/2024
Date Signed: 12/06/2024 03:14:46 PM

Document Has Been Signed on 12/06/2024 03:14 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:AIM HIGHER, INC.FACILITY NUMBER:
435202216
ADMINISTRATOR/
DIRECTOR:
MARINA DAVIDFACILITY TYPE:
775
ADDRESS:90 GREAT OAKS BLVD., STE. #101TELEPHONE:
(408) 599-3155
CITY:SAN JOSESTATE: CAZIP CODE:
95119
CAPACITY: 80CENSUS: 33DATE:
12/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Shaterica IslesTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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Licensing Program Analysts LPA Santino Fortes and Licensing Program Manager LPM Jackie Jin conducted an unannounced annual inspection, and met with Program Director Shaterica Isles (PD). PD informed that facility has 14 staff and 33 clients.

LPAs toured the facility inside out including: kitchen, lobby, 3 classrooms, 1 multipurpose room and 1 unused staff room, reception area/reception office, changing room and the program director office. 2 Hallway Restrooms observed with water temperature observed at 113.1 Degrees F. Kitchen area and no detergents or sharps were observed to be stored. Refrigerator in kitchen area was operating properly. During visit a paper cutter was observed to be in the unused overflow activity room. During the visit PD stored the paper cutter in a locked office. The patio, outside rest area was observed to be clear of obstructions and building exits clear of obstructions. The changing room was observed to be clean and without odor. Residents were observed to be participating in a dancing/exercise activity. LPA observed Facility License and Resident Personal rights were posted.

LPA observed the medication storage area, and cleaning product storage area as locked and inaccessible to clients in care. Room temperature was observed at 68 degree F. LPA inspected the facility first aid kit and it was observed to be lacking the First aid instructional booklet. PD replaced the first aid instructional booklet inside the First aid kit during the visit. The facility was equipped with smoke and carbon monoxide detector in the main activity room. Fire extinguisher was last serviced on 9/16/24 . The facility conducted their last fire drill on Aug 15, 2024. One faucet was observed to be out of order in the women's rest room. There was a work order made to repair the faucet, but other sinks were available to residents for hand washing. A technical violation was provided for the faucet.

See Lic809-C for continuation
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Santino Fortes
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: AIM HIGHER, INC.
FACILITY NUMBER: 435202216
VISIT DATE: 12/06/2024
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4 transit vans were observed to be used for transporting clients from their residence to the day program and community outings. The transit vans were last serviced on 10/20/24. Transit vans are scheduled for service every 5000 miles.

LPA reviewed facility records for 5 staff, 8 clients files and observed to be complete. LPA reviewed 1 client medications and centrally stored medication records and were observed to be complete. LPA reviewed 5 resident Cash resources and were observed to be accurate.

No deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with PD. This report was reviewed and a copy was provided to PD for signature.

SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Santino Fortes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
LIC809 (FAS) - (06/04)
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