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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306005960
Report Date:
01/16/2025
Date Signed:
01/16/2025 04:18:10 PM
Document Has Been Signed on
01/16/2025 04:18 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
ORANGE COUNTY RO
,
770 THE CITY DR., SUITE 7100
ORANGE
,
CA
92868
FACILITY NAME:
WOODBRIDGE TERRACE
FACILITY NUMBER:
306005960
ADMINISTRATOR/
DIRECTOR:
CHRISTIAN OTBO
FACILITY TYPE:
740
ADDRESS:
1 WITHERSPOON
TELEPHONE:
(949) 654-8500
CITY:
IRVINE
STATE:
CA
ZIP CODE:
92604
CAPACITY:
180
CENSUS:
133
DATE:
01/16/2025
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
04:14 PM
MET WITH:
Christian Otbo
TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today's visit was to conduct a case management. LPA Tea was greeted and granted entry into the facility by Executive Director (ED) Christian Otbo.
On this day LPA Tea amended LIC9099 dated 01/16/2025. LPA reviewed amended report with executive director.
An exit interview was conducted with the ED Otbo. A copy of this report and amended LIC9099 was provided to the facility.
SUPERVISORS NAME
:
Alisa Ortiz
LICENSING EVALUATOR NAME
:
Michael Tea
LICENSING EVALUATOR SIGNATURE
:
DATE:
01/16/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
01/16/2025
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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