<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202347
Report Date: 04/21/2025
Date Signed: 04/21/2025 12:12:12 PM

Document Has Been Signed on 04/21/2025 12:12 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:
435202347
ADMINISTRATOR/
DIRECTOR:		MARINA DAVIDFACILITY TYPE:
775
ADDRESS:1237 REAMWOOD DRIVETELEPHONE:
(408) 462-9811
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY: 80CENSUS: 39DATE:
04/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Alisha Roswall, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On April 21, 2025, at 8:50 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with the Program Director (PD), Alisha Roswall, and disclosed the purpose of the inspection. PD informed the LPA that the facility had (39) clients and (10) staff members present at the time.

LPA toured the physical plant and observed that it was clean, odor-free, maintained at a comfortable indoor temperature of 68°F, and had adequate lighting. LPA inspected the multipurpose room, computer lab, and three classrooms (#1, #2, and #3). Clients were observed participating in various activities, including a talent show, one-on-one cooking, and arts and crafts. The hallways and emergency exits were free of obstructions and did not present any blocking or tripping hazards. LPA did not observe any designated outdoor area for client use. No accessible bodies of water or safety hazards were observed.

LPA inspected the locked break room and observed that knives and other sharp objects were stored securely inside a locked cabinet, making them inaccessible to clients. No cooking or meal preparation were observed in the break room. The PD stated that clients bring their own meals. LPA inspected the refrigerator and observed juice and other food items stored inside. The PD explained that the refrigerator was used to store items for the one-on-one cooking class and not for client meals or medications. Staff members assist clients in heating their meals in the microwave if they bring hot lunches.

LPA inspected the locked storage room and observed that cleaning supplies and chemicals were properly stored and locked, making them inaccessible to clients.

Continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: April Cowan
NAME OF LICENSING PROGRAM ANALYST: Kiran Jain
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2025
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
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: 435202347
VISIT DATE: 04/21/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA inspected the bathrooms and observed them to be clean and equipped with trash cans, liquid soap, paper towels, and non-slip flooring. The hot water temperature in the men’s bathroom was measured at 108.7°F.

LPA observed a fire extinguisher mounted on the hallway wall and confirmed it was fully charged, with the most recent service tag dated 09/16/2024. A staff member tested the carbon monoxide detector in the hallway in the presence of the LPA, and it was found to be functional. LPA reviewed the Fire Prevention routine inspection report, which was conducted on March 25, 2025, by the Department of Public Safety Fire Prevention & Hazardous Materials Certified Unified Program Agency, City of Sunnyvale. The annual inspections of the fire alarm and fire protection sprinkler systems were last completed on June 28, 2024.

LPA reviewed five (5) randomly selected client files and five (5) staff personnel records. All five client files contained the Admission Agreement, Physician’s Report, and Appraisal/Needs and Services Plan. All five staff files contained current First Aid/CPR certifications, LIC 508 Criminal Record Statements, and LIC 503 Health Screenings. LPA confirmed that all five staff members were associated with the facility.

The First Aid kit was checked and found to be fully stocked. LPA reviewed the Emergency Drill Logs and confirmed that drills were conducted quarterly, with the most recent drill held on 03/04/2025. The facility’s vehicle maintenance records were reviewed and indicated routine servicing, with the most recent maintenance performed on 04/18/2025.

Two (2) clients’ PRN medications were observed to be securely stored in a locked safe box in the reception area. Centrally Stored Medication Records were reviewed and found to be complete. The client’s Personal & Incidental (P&I) funds were counted by the PD in the presence of the LPA and were found to be accurate.

The following updated forms are requested to be submitted to CCLD by 04/28/2025:

  • LIC 500: Personnel Report
  • LIC 308: Designation of Facility Responsibility
  • LIC 999: Updated Facility Sketch (Floor Plan)
  • LIC 400: Resident Cash Resources Affidavit

Continued on LIC809-C
NAME OF LICENSING PROGRAM MANAGER: April Cowan
NAME OF LICENSING PROGRAM ANALYST: Kiran Jain
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: 435202347
VISIT DATE: 04/21/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
  • LIC 402: Surety Bond
  • Certificate of Liability Insurance

No deficiencies were cited during today's visit.

An exit interview was conducted with the Program Director. A copy of this report was provided to the Program Director, Alisha Roswall, whose signature on this form confirms receipt of the report.

NAME OF LICENSING PROGRAM MANAGER: April Cowan
NAME OF LICENSING PROGRAM ANALYST: Kiran Jain
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4