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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006073
Report Date: 10/18/2023
Date Signed: 10/18/2023 11:22:14 AM

Document Has Been Signed on 10/18/2023 11:22 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, 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:
(949) 617-5642
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 6CENSUS: 4DATE:
10/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:Veronica Hernandez, Melody FathiTIME COMPLETED:
11:35 AM
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This unannounced Case Management – Other inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering an amended report for the Case Management – Incident inspection conducted on 09/06/23. LPA met with Staff #1 (S1) Veronica Hernandez and discussed the purpose of the inspection. Administrator (AD) Christina Khouie appeared via telephone. Program Director (PD) Melody Fathi arrived during the inspection.

During the inspection, LPA and PD reviewed and discussed the previously delivered report and the amended report and LPA delivered the amended report to PD.

An exit interview was conducted and copies of this report and the amended report were discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2023
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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