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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006073
Report Date: 03/30/2022
Date Signed: 03/30/2022 12:48:33 PM

Document Has Been Signed on 03/30/2022 12:48 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:EDEN BY ENHANCEFACILITY NUMBER:
306006073
ADMINISTRATOR:KHOUIE, CHRISTINAFACILITY TYPE:
772
ADDRESS:35 MANN STREETTELEPHONE:
(714) 475-7013
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 6CENSUS: 0DATE:
03/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Christina KhouieTIME COMPLETED:
01:00 PM
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Licensing Program Analysts (LPAs) Ruth Martinez and Celine De Perio made an unannounced site visit to the facility on this date for the purpose of delivering an amended pre-licensing report originally issued on 03/07/2022. In order for report to reflect proper facility structure to one story home.

LPAs arrived at facility was greeted at the door by Christina Khouie, Administrator and granted entry. LPAs met with Administrator and explained the nature of today's visit.

Exit interview was conducted with Administrator and a copy of this LIC809 report was left with the Administrator, along with copies of amended reports.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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