191202140-6-3-2026-31-AS-NRED-DUPR5H-20260603124310

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191202140
Report Date: 06/03/2026
Date Signed: 06/03/2026 12:45:10 PM

Document Has Been Signed on 06/03/2026 12:45 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	TOPANGA-WEST GUEST HOME		FACILITY NUMBER:	191202140
ADMINISTRATOR/ DIRECTOR:	GREGORY ERDOSI		FACILITY TYPE:	735
ADDRESS:	22115 ROSCOE BLVD		TELEPHONE:	(818) 884-8100
CITY:	CANOGA PARK	STATE: CA	ZIP CODE:	91304
CAPACITY: 78		CENSUS: 50	DATE:	06/03/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Gregory Erdosi		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

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At approximately 9:00 a.m. on 06/03/26, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator and disclosed the reason for the visit. LPA and the administrator toured the facility inside and out.

The facility was last inspected on 06/24/25 for a complaint visit. It is a single story building with a lobby, offices, shared bedrooms with private bathrooms, public bathrooms, shower rooms, library, laundry rooms, medication room, kitchen, dining area, recreation rooms, and courtyard. It has an approved fire clearance for 78 residents of which eight (08) may be non-ambulatory.

The front doors are locked from the outside for security. Upon entry, LPA observed postings for the visitation policy, COVID precaution, emergency disaster plan, facility sketch, facility license, personal rights, and house rules. A screening station at the front contained a digital thermometer, hand sanitizer, visitor log, and resident log. Offices near the lobby contained the facility call system and locked facility files. Confidential complaint poster, Ombudsman contact, activity schedule, and weekly menu were posted in the hallway.

LPA observed a small, locked laundry room near the office for resident use. The room contained two washers and two dryers. All machines were functional. Detergents were locked above the machines. A large laundry room was located near the northeast exit. The janitorial closet near the laundry rooms was locked. It contained cleaning solutions and tools. Other locked storage areas in the hallways contained supplies and emergency water. Shaded patio furniture in the courtyard and outside were in good condition.

All kitchen surfaces and floor were clean and free from debris and hazards. A menu was posted in the dining room. A house phone was located in the dining room and in the main hallway. At 9:30 a.m. LPA tested the phone to be operable. The medication room was locked and contained locked medication carts, confidential files, medication refrigerators, and a first aid kit. Showers in the shower room contained grab bars, a non skid surface, and pull cords for the call system.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/03/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: TOPANGA-WEST GUEST HOME	FACILITY NUMBER: 191202140
	VISIT DATE: 06/03/2026

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LPA inspected room A-3. The room was clean and contained a chair, nightstand, lamp, and chest of drawers. The bathroom contained a night light, grab bars, pull cords for the call system, handwashing instruction sign, liquid soap, and personal hand towel. Hot water temperatures in the resident bathroom and the public restroom were tested at 9:40 a.m. and 11:15 a.m. to be 105.4 degrees Fahrenheit and 107.9 degrees Fahrenheit. At 10:00 a.m. LPA measured the internal temperature to be 71 degrees Fahrenheit. All floors, windows, ceilings, and walls were clean and in good condition. Carbon monoxide and smoke detectors were tested at 10:15 a.m. and 10:25 a.m. and were deemed operational. Evacuation routes are clearly labelled and posted throughout the facility. Emergency exit routes were unlocked and free from obstruction. At approximately 11:15 a.m. LPA observed fully-charged fire extinguishers in the hallways which were last inspected on 08/15/25. The facility has fire sprinklers in all hallways and rooms. Surveillance cameras are used in hallways.

At 11:30 a.m., LPA conducted a file review of resident and personnel files, liability insurance, and REG4 fire testing. All files were complete, up to date, and available for audit.

During today's visit, the facility is in compliance with Title 22 regulations, no citations issued.

Exit interview conducted. Copy of report issued.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/03/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2026

LIC809 (FAS) - (06/04)

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