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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006073
Report Date: 12/21/2023
Date Signed: 12/28/2023 12:59:54 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
12/12/2023 and conducted by Evaluator Celine DePerio
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231212162040
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: 1DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
02:19 PM
MET WITH:Program Director - Guy GrimesTIME COMPLETED:
04:55 PM
ALLEGATION(S):
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Facility staff do not have the proper background clearance
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit to the facility to deliver the findings. LPA De Perio explained the purpose of today's visit, was greeted, and granted entry by Program Director (PD) Guy Grimes.

It was alleged that facility staff do not have the proper background clearance. LPA De Perio conducted 2 client interviews that did not provide further information regarding this allegation. The 2 staff interviews corroborated with the allegation by stating that staff 1 (S1) will go to the facility to pick up mail. Per documentation review, from October 2023 to December 2023, LPA De Perio observed that S1 signed into the facility under the “Visitor Log” seven times. Documentation review also revealed that S1 had an exemption denial dated for July 31, 2023.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
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 5
Control Number 22-AS-20231212162040
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
VISIT DATE: 12/21/2023
NARRATIVE
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The exemption denial that was issued stated that (S1) “may not work or be present in an agency licensed by the Department, may not reside or be regularly present” and is “prohibited from having contact with clients, potential clients or confidential client information of any agency, licensed by the Department”.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, the preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED.

An exit interview was conducted with PD Grimes.

A copy of this report was explained, and appeal rights were provided during the visit

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
12/12/2023 and conducted by Evaluator Celine DePerio
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231212162040

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: 1DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
02:19 PM
MET WITH:Program Director - Guy GrimesTIME COMPLETED:
04:55 PM
ALLEGATION(S):
1
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9
Facility does not maintain the proper staffing ratios.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit to the facility to deliver the findings. LPA De Perio explained the purpose of today's visit, was greeted, and granted entry by Program Director (PD) Guy Grimes.

It was alleged that the facility does not maintain the proper staffing ratios. LPA De Perio conducted a total of 2 staff interviews that did not corroborate with the allegation. LPA De Perio conducted a total of 2 client interviews that also did not corroborate with the allegation. Per staff schedule for December 2023, it was observed that per shift there were a minimum of 2 staff members a shift for a census 2 of clients.
Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA is unable to ascertain if the allegation occurred as reported.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20231212162040
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
VISIT DATE: 12/21/2023
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted with PD Grimes.

A copy of this report was provided and explained.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20231212162040
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: 12/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/22/2023
Section Cited
CCR
81019(a)
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81019 Criminal Record Clearance
(a) The Department shall conduct a criminal record review of all individuals specified in Health and Safety Code section 1522(b), and shall have the authority to approve or deny...
This requirement is not met as evidence by:
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As a plan of correction (POC), licensee will ensure that S1 will not go be present at the facility, and will appoint S1's responsibilities to another designated staff member who has been background cleared on or by 12/22/23.
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Based on LPA's interviews and review of documents obtained, there was an exemption denial issued for staff (S1) on July 31, 2023, however, per facility visitor log, S1 went to the facility seven times between the months of October 2023 and December 2023. This poses an immediate health and safety risk to clients in care.
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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: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5