<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006073
Report Date: 06/01/2023
Date Signed: 06/01/2023 05:15:28 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2023 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230517155107
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: 4DATE:
06/01/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Adrian DiazTIME COMPLETED:
05:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to administer client's medication.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation into the allegation listed above. LPA met with the Operations Manager Adrian Diaz and explained the reason for the visit. The investigation into the allegation revealed the following. Client 1 (C1) was admitted to the facility on 5/9/23 and left the facility (discharged) at their request on 5/12/23. It was alleged that the facility failed to administer C1's medication. A review of records shows C1 was prescribed 5 medications upon being admitted to the facility. The medication administration record (MAR) shows C1 was not administered Duloxetine Hcl 60mg on 5/11/23. C1 received the rest of their medications that day. Staff interviewed could not explain or provide verification as to why the medication was not administered or why there was no record of it being refused. Based on information gathered through record review and interviews the preponderance of evidence standard has been met, therefore, the allegation, facility failed to administer client's medication, is found to be SUBSTANTIATED. Violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 2. An exit interview was conducted and a copy of this report along with citation and Appeal Rights (LIC 9058 3/22) was provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 22-AS-20230517155107
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 ENHANCE
FACILITY NUMBER: 306006073
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/02/2023
Section Cited
CCR
81075(b)(5)(B)
1
2
3
4
5
6
7
Once ordered by the physician the medication is given according to the physician's directions.
This requirement is not being met as evidenced by;
1
2
3
4
5
6
7
Licensee agrees to ensure staff administer all client medications as prescribed and to properly record the administration of all medication. In addition all staff will be trained on the proper administration of medication along with training on CCR 81075.
8
9
10
11
12
13
14
A review of records shows Client 1 (C1) was not administered Duloxetine Hcl 60mg on 5/11/23. This poses an immediate Health and Safety Risk to clients in care.
8
9
10
11
12
13
14
 Proof of training to be submitted to the LPA by the POC due date.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2023 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230517155107

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: 3DATE:
06/01/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Adrian DiazTIME COMPLETED:
05:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to ensure clients are being provided care and supervision.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation into the allegation listed above. LPA met with the Operations Manager Adrian Diaz and explained the reason for the visit. The investigation into the allegation revealed the following. It was alleged that facility failed to ensure clients are being provided care and supervision. It was reported that clients were being neglected by the facility. No details were provided. The clients residing at the facility declined to be interviewed. Staff reported that all clients are treated with dignity and respect. Staff reported that none of the clients have reported any issues regarding care and supervision or being neglected in anyway. LPA toured the facility on 5/25/23 and 6/1/23 and observed that on each visit there was a minimum of 3 staff present. Staff reported that overnight there is at least on staff member always present at the facility. No evidence was provided to corroborate the allegation. Based on the evidence gathered, the allegation, facility failed to ensure clients are being provided care and supervision is deemed unsubstantiated. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4