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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006073
Report Date: 03/14/2024
Date Signed: 03/14/2024 11:02:33 AM

Document Has Been Signed on 03/14/2024 11:02 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:EDEN BY ENHANCEFACILITY NUMBER:
306006073
ADMINISTRATOR:RUTH KHAYFACILITY TYPE:
772
ADDRESS:35 MANN STREETTELEPHONE:
(949) 503-3553
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 6CENSUS: 3DATE:
03/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:41 AM
MET WITH:Program Director- Christina Khouie TIME COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced case management visit in conjunction with complaint: 22-AS-20230503092050.

LPA De Perio explained reason for visit, was greeted and granted entry by Program Director (PD) Christina Khouie.

For this visit, LPA De Perio conducted a tour of the facility, reviewed records and conducted interviews.

During the tour of the facility, LPA De Perio observed that there are a total of 3 clients present.

Upon conducting the record reviews, LPA De Perio observed that per facility plan of operation, facility conducts room checks on clients every 15-30 minutes for 24-hours, and is documented via "Rounds Log", and also states that rooms must be unlocked, but does not specify if doors are to be closed or opened when clients sleep.

For this visit, LPA De Perio conducted interviews with staff and clients, and requested copies of records reviewed.

No citations were issued.

An exit interview was conducted with PD Khouie.

A copy of this report was provided and explained.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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