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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202347
Report Date: 05/31/2022
Date Signed: 05/31/2022 03:05:59 PM

Document Has Been Signed on 05/31/2022 03:05 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
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:AIM HIGHER INC.FACILITY NUMBER:
435202347
ADMINISTRATOR:MARINA DAVIDFACILITY TYPE:
775
ADDRESS:1237 REAMWOOD DRIVETELEPHONE:
(408) 462-9811
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY: 80CENSUS: 72DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:David LopezTIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Ryker Heberle conducted an unannounced Required - 1 Year visit on 05/31/2022 at 02:01pm and met with Program Director David Lopez (Admin).

LPA toured the facility. The facility is currently operating in a reduced capacity due to the COVID-19 pandemic, offering online services to most of its clients. LPA toured the reception area, activity room, physical activity room, staff kitchen, 2 bathrooms, isolation room, classroom, and storage room. The facility currently has clients attending the program. LPA was screened for symptoms and temperature upon entrance into the facility at designated entry point. All staff members observed to be wearing masks. LPA observed COVID-19 related posters displayed throughout the facility. LPA observed that the facility has a 30 day supply of PPE.

No prohibited items noted in facility. All emergency exits noted to be clear of obstruction. All rooms in facility noted to be clean and well maintained. Hand sanitizers, soap, and paper supplies were observed to be available. Food is not offered to clients at the facility, nor is medication administered at the facility. Fire extinguishers observed to have been inspected in August of 2021. Carbon monoxide detector tested and observed to be operational.

All restrooms stocked with paper towels. Hand washing signs observed in all bathrooms. Facility water temperature measured at 113.9 *F Social distancing signs observed to be posted in all public areas. Facility was observed to have a designated room for residents to isolate in the event of manifestation of symptoms. Vaccination rate for staff and clients is currently at 100%.

No deficiencies cited during today's visit. This report was reviewed with Program Director David Lopez and a copy of the signed report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Ryker Heberle
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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