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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606312
Report Date: 11/13/2023
Date Signed: 11/13/2023 02:27:29 PM

Document Has Been Signed on 11/13/2023 02:27 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:RIDGEWOOD RESIDENTIAL CARE, INC.FACILITY NUMBER:
197606312
ADMINISTRATOR:MARIA VICTORIA HAMOYFACILITY TYPE:
735
ADDRESS:9403 GERALD AVENUETELEPHONE:
(818) 886-6750
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY: 6CENSUS: 6DATE:
11/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Karla Plata Asst AdministratorTIME COMPLETED:
02:27 PM
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Licensing Program Analyst (LPAs), Tihesha Smith and Gina Saucedo conducted an unannounced Required 1-year inspection at this facility 10:20 am. LPA disclosed to the staff the purpose of the visit. The administrator was called and arrived later.

LPA conducted a tour of the physical plant at approximately 10:50 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen with breakfast nook area, formal dining room and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to have adequate seating for residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The
kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Secondary fridge in detached garage with excess food items. Resident medications and stocked first aid kits stored in cabinets in laundry area. Medications observed to be locked and inaccessible to residents in care. Toxins are stored and locked in laundry room in lower cabinet. The cabinet containing the toxins observed to be locked and inaccessible to residents.

The sharps are stored in same locked cabinet as the toxins. There is one (1) fire extinguisher attached to wall in breakfast nook area.

Laundry room is located at back of kitchen. The appliances observed to be functional.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: RIDGEWOOD RESIDENTIAL CARE, INC.
FACILITY NUMBER: 197606312
VISIT DATE: 11/13/2023
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(Cont from 809)

The resident bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. LPA observed a supply of linens in hallway cabinets.

Each bathroom has posted “wash your hands” signs and the following items available: hand soap, paper
towels, and trash cans. The hot water temperature was measured for the two (2) bathrooms to ensure it is
within the required range for residents’ comfort and safety. The water temperature range was between 110.0- and 110.1 -degrees Fahrenheit.

Backyard has the following: Covered patio with park table/chair combination; and four (4) folding chairs available for seating. Patio furniture observed to be in good repair.

Detached Garage: Used for Food storage, PPEs, and storage.

Smoke detectors/carbon monoxide detector were tested and operable at time of visit.

Facility grounds were free of hazards.

At approximately 12:35 pm to 1:45 pm, LPA reviewed three (3) staff files and six (6) resident files. Staff files had the appropriate trainings to include First aid and CPR. Six (6) out of Six (6) resident files included medical assessments Behavior support and/or Individual program plan.

Exit Interview Conducted/Copy of the Report Issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2023
LIC809 (FAS) - (06/04)
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