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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850578
Report Date: 11/04/2025
Date Signed: 11/04/2025 02:02:36 PM

Document Has Been Signed on 11/04/2025 02:02 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:RIDGE AT WESTLAKE VILLAGE, THEFACILITY NUMBER:
195850578
ADMINISTRATOR/
DIRECTOR:		LARIOS, BRIANFACILITY TYPE:
740
ADDRESS:31200 CEDAR VALLEY DRIVETELEPHONE:
(805) 572-7705
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91362
CAPACITY: 162CENSUS: 88DATE:
11/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Brian LariosTIME VISIT/
INSPECTION COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Angela Barutyan conducted an unannounced case management - incident visit at 12:50PM. Upon arrival, LPA met with staff and Executive Director (ED) Brian Larios. Entrance interview conducted.

During today’s visit, LPA conducted a brief physical plant tour, conducted interviews with ED and Health and Services Director Ian Gadea, and reviewed and obtained copies of pertinent documents relevant to the investigation.

On 10/27/2025, the Department received an incident report stating that on 10/20/2025 around 01:30PM, a staff member heard Resident #1 (R1) call for help from their apartment and staff observed R1 laying on the floor. R1 was transported to the hospital, and it was determined that R1 had fractured both femurs and their left arm. During today’s visit, LPA conducted a file review and observed that R1’s physician’s report signed and dated 08/18/2025 documents R1 with osteopenia and osteoarthritis, affecting bone mass and density. R1’s care plan signed and dated 09/03/2025 documents that R1 “requires one-person physical assistance with transfers.” However, R1 attempted to self-transfer and tripped on their wheelchair. LPA reviewed pendant response times and observed that on 10/20/2025, R1 pressed their pendant at 01:31PM and it was cleared by staff at 01:34PM. 9-1-1 was called by staff at 01:34PM. LPA observed R1's room and did not observe any tripping hazards or immediate health and safety concerns.


Report Continued on LIC809-C.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Angela Barutyan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2025
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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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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: RIDGE AT WESTLAKE VILLAGE, THE
FACILITY NUMBER: 195850578
VISIT DATE: 11/04/2025
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Furthermore, on 10/27/2025, the Department also received multiple incident reports for incidents that occurred on the following dates: 09/25/2025, 09/27/2025, 09/29/2025, 10/01/2025, and 10/11/2025. Regulation states that incident reports shall be submitted within seven (7) days of occurrence. LPA discussed reporting requirements with the ED. ED stated that a plan has been put in place to ensure that the timeline for incident reporting will be in compliance.

Pursuant to Title 22, CA Code of Regulations, the following deficiency was cited for reporting requirements (refer to LIC 809-D). Administrator was informed that failure to correct deficiency may result in civil penalties.

An additional report may follow if warranted.

Exit interview conducted, report issued, and appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Angela Barutyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/04/2025 02:02 PM - It Cannot Be Edited


Created By: Angela Barutyan On 11/04/2025 at 01:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: RIDGE AT WESTLAKE VILLAGE, THE
FACILITY NUMBER: 195850578

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/11/2025
Section Cited
CCR
87211(a)(1)

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Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports...(1) A written report shall be submitted to the licensing agency...within seven days of the occurrence...
This requirement is not met as evidenced by:
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ED stated that a plan has been put in place to ensure that incident reports get submitted in compliance. ED stated they will conduct training on reporting requirements and submit the written plan to CCLD by the due date.
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Based on record review and interview, the licensee did not comply with the section cited above as six (6) incident reports were submitted after seven days of occurrence. This poses a potential health, safety, and personal rights risk to persons 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.
Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:
Angela Barutyan
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2025


LIC809 (FAS) - (06/04)
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