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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006073
Report Date: 02/21/2023
Date Signed: 02/21/2023 03:55:44 PM

Document Has Been Signed on 02/21/2023 03:55 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: 2DATE:
02/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:06 PM
MET WITH:Operations Manager - Maria DiazTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced case management visit to facility regarding complaint: 22-AS-20230209094038 to issue a civil penalty (see LIC9099-D dated for 2/14/23).

LPA De Perio was greeted and granted entry by staff on duty, and explained reason for visit.

For today's visit, there are a total of 2 clients in care and 3 staff on duty. LPA De Perio met with Operations Manager (OM) Maria Diaz.

A civil penalty was issued - (see LIC421 FC - assessed on 2/21/23).

An exit interview was conducted with OM Diaz and a copy of this report, and civil penalty was provided to the facility.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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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