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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701065
Report Date: 02/07/2022
Date Signed: 02/08/2022 02:24:59 PM

Document Has Been Signed on 02/08/2022 02:24 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:AIM HIGHER, INC.FACILITY NUMBER:
502701065
ADMINISTRATOR:WOODFORD, MAXFACILITY TYPE:
775
ADDRESS:318 MCHENRY AVETELEPHONE:
(916) 835-2933
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: 80CENSUS: 0DATE:
02/07/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tiffany Stevenson and Max WoodfordTIME COMPLETED:
03:00 PM
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Announced Prelicensing visit made out to this day program by LPA Charlie Yang on 02/07/2022 and was met by the day program Director, Tiffany Stevenson, and Executive Director, Max Woodford, who were briefly interviewed.
This day program is seeking licensure to accept and serve up to 80 clients, of which 10 can be non ambulatory, at any given time.
This day program will also maintain a 1:4 staff to client ratio as specified with Valley Mountain Regional Center.
Current census was 0 clients.
Tour of the day program was conducted.
This day program contained a large multipurpose room surrounded by offices and additional rooms throughout this building.
A tour of the separate offices and additional rooms was conducted. It was learned that these additional rooms were to be used as classrooms and spaces intended for client use as needed. Foldable tables and chairs were set up in order to accommodate several activities and program choices for the day.
A tour of the program restrooms was conducted. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees.
Fire extinguishers, located throughout this day program, were observed to have been annually inspected on 09/08/2021 by the local fire extinguisher company, Fire Code, and in compliance at this time.
Kitchen area was toured. It was learned that there will not be a stove or oven made available at this day program. All meals will be brought into this day program by the clients and their respective providers while in attendance. A hot plate was observed to be present and will be in use during program hours.
Exterior grounds of this day program were toured. Entrance area for admission of the clients and transportation drop off/pick up was reviewed.
There were no deficiencies observed or cited during today's Prelicensing visit.

Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2022
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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