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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408887
Report Date: 08/23/2023
Date Signed: 08/23/2023 10:23:39 AM

Document Has Been Signed on 08/23/2023 10:23 AM - 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:AIM HIGH CHILD CARE CENTER, INC., TIMBER POINTFACILITY NUMBER:
073408887
ADMINISTRATOR:LIVIER ALDANAFACILITY TYPE:
850
ADDRESS:40 NEWBURY LANETELEPHONE:
(925) 809-7550
CITY:DISCOVERY BAYSTATE: CAZIP CODE:
94505
CAPACITY: 60TOTAL ENROLLED CHILDREN: 45CENSUS: 24DATE:
08/23/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
07:15 AM
MET WITH:Livier AldanaTIME COMPLETED:
10:30 AM
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Licensing Program Analysts (LPA) Cherie Acosta and Sikia Blue conducted an unannounced Case Management inspection. LPAs met with Director Livier Aldana.

During the course of a complaint investigation, it is determined that the facility failed to notify parent of a wound. Based on interviews conducted a child in care had a burn on his leg. It is not determined how or where the child received the burn. While child was in care on 7/5/23, the wound began to ooze.. Facility staff put a band aid on the wound but did not notify the parent that the wound was oozing.

There was also another incident involving the same child. On 3/23/23 the child hit his lip while playing on the seesaw. The parent was not notified of the incident when picking up the child. An ouch report was provided to the parent after the parent notified the facility of the injury.

See 809-D for deficiency cited today.
Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Livier Aldana.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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Document Has Been Signed on 08/23/2023 10:23 AM - It Cannot Be Edited


Created By: Cherie Acosta On 08/23/2023 at 08:40 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AIM HIGH CHILD CARE CENTER, INC., TIMBER POINT
FACILITY NUMBER: 073408887

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2023
Section Cited
CCR
101226.3(b)

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Observation of the Child. Any unusual behavior, any injury or signs of illness requiring assessment and/or administration of first aid by staff shall be reported to the child's authorized representative and recorded in the child's record.
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Director shall develop a written plan to ensure parents are notified of injuries. Director shall send a copy of the written plan to CCL by 9/1/23.
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This requirement was not met as evidenced by: there were two separate incidents where parent was not notified of child having a wound that required first aid which poses a potential risk to the health and safety of children in care.
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• Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Sherelle Johnson
LICENSING EVALUATOR NAME:Cherie Acosta
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2023


LIC809 (FAS) - (06/04)
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