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ICF/DD-H (Habilitative)License activeMedi-Cal certified

ENRICHING LIVES III

ICF/DD-H (Habilitative) · 6 licensed beds · Costa Mesa, CA

Homes of 4–15 beds for people with developmental disabilities whose nursing needs are intermittent and predictable.

Address

ENRICHING LIVES III2507 CHRISTOPHER LNCosta Mesa, CA 92626 · Orange County

Phone: (562) 331-5055

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
ENRICHING LIVES INC. · Profit Corp
Administrator
HARRIS, SHANNON
CDPH facility ID
060001034
License number
060000279
First licensed
August 10, 1990
Current license
Nov 27, 2025 to Nov 26, 2026
CDPH district office
Orange

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G478
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
November 26, 1990
Last certification survey
October 17, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership change (CMS)
June 13, 2012
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 0 · direct care 11.5 · all employees 12.5

State citations and penalties (CDPH)

2 penalties, newest first

CDPH issues citations under Health and Safety Code §1424: Class AA (a violation that was a substantial factor in a resident's death), Class A (imminent danger or a substantial probability of death or serious harm) and Class B (a direct relationship to residents' health, safety or security). State citations explained

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Apr 16, 2019 · Penalty #060015076 · Survey 42Y011

    Status: Closed · Not appealed

    $1,000

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Apr 25, 2016 · Penalty #060012331 · Survey LFRG11

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

30 surveys since 2018 · CMS data through Oct 12, 2026

CDPH surveys certified ICFs for CMS. Each deficiency is a W-tag (a federal ICF/IID requirement), an E-tag (emergency preparedness) or a K-tag (Life Safety Code), cited at the standard level or, more seriously, the condition level. How to read an ICF inspection

Content note: these federal findings describe residents' care and can include abuse, neglect, injuries and medical details. They're shown as CMS published them; residents are identified only by number (such as "Client 1").

  1. · Complaint

    Event 25D619-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event 9QY611 · 1 deficiency

    Official 2567 ↗
  3. · Recertification

    Event ER0F21 · 5 deficiencies

    Official 2567 ↗
  4. · Complaint, Recertification

    Event ER0F11 · 14 deficiencies

    Official 2567 ↗
  5. · Complaint

    Event BLYP11 · no deficiencies cited

    Official 2567 ↗
  6. · Recertification

    Event 1QMF21 · 10 deficiencies

    Official 2567 ↗
  7. · Complaint, Recertification

    Event 1QMF11 · 29 deficiencies (2 condition-level)

    Official 2567 ↗
  8. · Complaint

    Event 9ZRN11 · 2 deficiencies

    Official 2567 ↗
  9. · Complaint

    Event 7PLL11 · 1 deficiency

    Official 2567 ↗
  10. · Recertification

    Event QY5V21 · 1 deficiency

    Official 2567 ↗
  11. · Recertification

    Event QY5V11 · 16 deficiencies

    Official 2567 ↗
  12. · Complaint

    Event SW9G11 · no deficiencies cited

    Official 2567 ↗

From CMS's QCOR ICF/IID statement-of-deficiency download, saved Oct 26, 2026. CMS notes that ICF/IID data after March 19, 2026 may be incomplete while its systems migrate. Plans of correction and state-only (licensing) deficiencies aren't in that file; the official 2567 documents on CalHealthFind have them.

Complaints and reported incidents

CDPH doesn't publish complaints or facility-reported incidents as a bulk file, so they aren't on ICFLookup. Its CalHealthFind page for this facility lists them (intake date, allegation category and whether each was substantiated), along with state licensing deficiencies and ownership details.

Federal surveys that came from a complaint or an incident report do appear above, marked "Complaint" as the survey type.

Open this facility on CalHealthFind ↗How to file a complaint with CDPH

Change history

33 events, newest first

Dates marked "state record" are the agencies' own: the license date, federal survey dates and penalty issue dates. "Detected" changes are ones we noticed by comparing CDPH's monthly facility listing with the one before it, tracked since Oct 26, 2026.

  1. ReportFederal survey (complaint): no deficiencies(state record)

  2. ReportFederal survey (complaint): 1 deficiency(state record)

  3. ReportFederal survey (recertification): 5 deficiencies(state record)

  4. ReportFederal survey (complaint, recertification): 14 deficiencies(state record)

  5. ReportFederal survey (complaint): no deficiencies(state record)

  6. ReportFederal survey (recertification): 10 deficiencies(state record)

  7. ReportFederal survey (complaint, recertification): 29 deficiencies, 2 condition-level(state record)

  8. ReportFederal survey (complaint): 2 deficiencies(state record)

  9. ReportFederal survey (complaint): 1 deficiency(state record)

  10. ReportFederal survey (recertification): 1 deficiency(state record)

Sources: CDPH Licensed and Certified Healthcare Facility Listing (data as of Oct 16, 2026), CDPH State Enforcement Actions, and CMS's ICF/IID statement-of-deficiency (CMS-2567) and Provider of Services files. ICFLookup is not affiliated with CDPH or CMS; always confirm with CDPH's CalHealthFind ↗ before making a decision. See How our data works.