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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608054
Report Date: 01/14/2026
Date Signed: 01/14/2026 12:44:19 PM

Document Has Been Signed on 01/14/2026 12:44 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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:RIDGEWOOD RESIDENTIAL CARE HOME #4FACILITY NUMBER:
197608054
ADMINISTRATOR/
DIRECTOR:		MARIA ROWENA B. CRUZFACILITY TYPE:
735
ADDRESS:17245 EXETER PLACETELEPHONE:
(818) 866-6750
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY: 4CENSUS: 4DATE:
01/14/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Maria Rowena Cruz, AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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On 01/14/26 at 09:35 AM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with Karla Plata, Assistant Administrator and disclosed the purpose of the visit. The Administrator, Maria Rowena Cruz arrived shortly after.

LPA asked for the census, client, and staff files. There are four (4) male, non-verbal, level four (4) clients living at the above facility. A physical tour was conducted at 10:40AM and observed the following:



Kitchen area was sufficiently stocked with seven (7) days of perishable and seven (7) days of non-perishable food. There is one (1) refrigerator in the kitchen area. There is one (1) fire extinguisher that is fully charged and dated March 2025. The cabinets have canned goods with dates labeled on them. There is one (1) telephone line that is located on the kitchen counter.

Living and dining room furniture is accessible for four (4) clients. There is a television and enough seating for four (4) clients. Furniture was observed to be in good condition. There is no fireplace in the facility. There are smoke detectors all around the house and functional. There are carbon monoxide detectors in all the rooms. The facility temperature at 71 degrees Fahrenheit. There is extra linen located in a pantry door that is located in the living room area at the entrance of the facility.

Outside/Backyard: There is a backyard accessible to the clients for use with proper seating. The facility has a signal system. There is no pool/bodies of water.

809C-continued

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Gina Saucedo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: RIDGEWOOD RESIDENTIAL CARE HOME #4
FACILITY NUMBER: 197608054
VISIT DATE: 01/14/2026
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Bedrooms: There are six (6) bedrooms. Four (4) of the bedrooms is single, occupied and for clients. The other two (2) bedrooms are for staff. All bedrooms were toured and were properly furnished and have appropriate bedding and linens. There are two (2) bathrooms for client and staff use. One (1) by the dining/living room area. The other bathroom is located in the hallway in between the client rooms. The bathrooms have proper toiletry and grab bars. The bathroom temperatures of the water are within regulations reading at 119-120 degree Fahrenheit.

Staff Office: The medication is kept locked and secured in one (1) of the cabinet areas in the staff office. The sharps are also locked and secured in of the cabinet areas in the staff office. There is another telephone line located in the staff office. The YES sign, house rules, daily activity schedule, personal and client roster and the disaster plan located against the wall in the staff office. There is an extra refrigerator in the staff office.

There is a garage that is accessible through the dining/living room area. There is extra incontinence, water, ensure and the chemicals are locked and secured inaccessible to the clients. There is one (1) washer and dryer located in the garage.

The facility has three (3) transportation vans for client transportation.


Administrative: There is no annual fee that is due right now. The Insurance plan is updated and expires on 07/07/2026. At the entrance of the facility there is COVID signs against the wall.

Files: Four (4) clients files reviewed and five (5) staff files reviewed.

An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Gina Saucedo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026
LIC809 (FAS) - (06/04)
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