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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609930
Report Date: 02/18/2026
Date Signed: 02/18/2026 02:50:27 PM

Document Has Been Signed on 02/18/2026 02:50 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:VENTURAFACILITY NUMBER:
197609930
ADMINISTRATOR/
DIRECTOR:		CINDY GARCIAFACILITY TYPE:
735
ADDRESS:729 VENTURA STTELEPHONE:
(626) 529-3776
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY: 4CENSUS: 3DATE:
02/18/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Administrator, Cindy Garcia & General Manager, Juana Ivett BusbyTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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At 12:45pm Licensing Program Analysts (LPA) Antonia Alvizar-Ettima conducted an unannounced annual inspection at the facility stated above. LPA met with Direct Support Professional Mathew Solis, Administrator, General Manager who granted access to the facility and LPA explained the purpose of this visit.

The facility retains three (03) clients with intellectual disabilities, placed by the San Gabriel/Pomona Regional Center Level 7. The facility is fire cleared for four (04) ambulatory clients. At approximately 1:15pm LPA, and Administrator conducted a physical tour inside and outside. During the tour, LPA observed that the facility has (4) bedrooms and two (2) bathrooms. Earthquake drill was last conducted on 01/14/26 and Fire drill on 01/17/26. Required posting observed in facility (complaint hot line poster, personal rights, etc). There is no body of water in the facility. During the visit the facility is at 72 degrees Fahrenheit. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Bedrooms: Were toured and observed to be clean and properly furnished with appropriate dresser, bedding, and linens with sufficient lighting. Linen storage was also checked and observed to have ample supply of clean linen and towels in the hallway.

Bathrooms: Were observed to be clean, sanitary and with necessary supplies. Hot water temperature measured at a range of 106.2°F to 108.5°F and within the required range. LPA observed appropriate grab bar and had non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. Client’s personal hygiene supplied are kept in their personal space. Cleaning supplies are being stored in a locked cabinet in hallway. Towels and washcloths are not shared. Cont. LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2026
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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: VENTURA
FACILITY NUMBER: 197609930
VISIT DATE: 02/18/2026
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Cont. from LIC809

Kitchen: Was observed to be clean and sanitary. All disinfectants, cleaning solutions and other toxins were observed to be locked in hallway closet. Food: LPA observed at least two (02) days perishable and seven (07) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped, dated, and stored properly as well. Food storage and preparation areas are clean and inaccessible to pests. Canned non-expired food was stored in kitchen and extra in the pantry hallway. All knives and sharps are observed to be locked staff office in locked drawer and inaccessible to clients. The facility has a working gas stove, microwave, refrigerator and freezer.

Common Areas: These included the living room, family room and dining area for clients. The common areas were properly furnished. Furniture in common areas was observed to be in good repair. Fireplace was empty and non-operational. Staff office is located in the den. Dual smoke and carbon detectors were located throughout the facility and observed to be operational. Fire extinguisher are located in the living and family room. Fire extinguisher is fully charged and receipt of purchase date 12/26/25.No obstructions and or tripping hazards throughout the facility. Clients dining table fits four (04) clients and activity table fits five (05).

Outside Areas: Were observed with appropriate outdoor furniture, a covered shaded area for clients. Exit area are free of obstructions and hazards. LPA checked inside of the locked and inaccessible to clients shed detached to the house. Shed was used for facility maintenance purposes, extra cleaning supplies and holiday decorations. LPA discussed the importance of maintaining care and supervision to meet the needs of clients. There is no garage, only parking port.

Due to time constraints, LPA had to terminate the visit and will return on a later date to complete the Required - 1 Year inspection by reviewing medication, residents and staff records.

No deficiencies observed during this visit. Exit interview conducted. Copy of the report issued.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC809 (FAS) - (06/04)
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