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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610142
Report Date: 09/26/2025
Date Signed: 09/26/2025 12:57:57 PM

Document Has Been Signed on 09/26/2025 12:57 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:ATRIA TARZANAFACILITY NUMBER:
197610142
ADMINISTRATOR/
DIRECTOR:		IRMA ARTEAGAFACILITY TYPE:
740
ADDRESS:5325 ETIWANDA AVENUETELEPHONE:
(818) 483-6827
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY: 136CENSUS: 118DATE:
09/26/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Irma ArteagoTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Irma Arteaga, and explained the reason for the visit.

At approximately 9:00am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a four story building with 112 resident rooms, private and public bathrooms, kitchen and dining areas, common areas, outdoor areas, business offices, activity rooms, gym, medication room, salon, and underground garage. It has an approved fire clearance for 136 residents, of which 25 may be non-ambulatory. Approved hospice waivers for ten (10). The smoke alarms are interconnected with carbon monoxide detectors that functions properly. There are fire extinguisher located throughout the facility halls. The charge date for the fire extinguishers is 09/17/2025.

Kitchen: The kitchen appliances and fixtures are functional. LPA observed a sufficient amount of perishable and non-perishable food, sealed and properly stored. A daily menu is posted, and was reviewed. Alternate menu also available.

Resident Rooms: LPA inspected random rooms on all four floors. Resident rooms were properly furnished with appropriate beddings and linens. There is sufficient lighting. Rooms are observed clean and sanitary. Exits and passageways from each room were clear of obstruction.

Bathrooms: All resident rooms has their own private bathroom, which was observed to be properly supplied with functional fixtures. Hot water temperature taken in resident bathrooms had a range of 105 to 107 degrees Fahrenheit.
NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Michael Cava
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2025
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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ATRIA TARZANA
FACILITY NUMBER: 197610142
VISIT DATE: 09/26/2025
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Common Areas: The common areas inspected include the lobby, dining area, formal dining room, activity room, salon, business/computer room and gym. Common areas are properly furnished. Sufficient seating observed at the dining areas. The furniture and gym equipment are all in good repair. The last fire safety inspection, conducted by the State Fire Marshall was made on 09/17/25. Smoke alarms/detectors, fire doors, generators and elevators passed. Inspection for sprinklers not due for another five years. Emergency/Evacuation drill was last conducted on May 29, 2025. Vehicle registration with the Department of Motor Vehicles (DMV) is up to date. California Highway Patrol (CHP) last held seat belt inspection on facility vehicles in August 2025.

Surrounding Grounds: Entry/exits were free of obstruction. There is furniture appropriate for outdoor use. There is an outdoor jacuzzi that is gated and locked. The fence around it’s parameters is approximately five feet.

Laundry: There is an industrial laundry area located on the first floor. In addition, all resident bedrooms are equipped with a washer/dryer.

Resident Files: Resident records are kept locked in the medication room. LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: Staff records are stored in a director's office. LPA conducted a file review of staff records to insure licensing forms and training are up to date and compliant.

Medications: Medication room is located on the first floor. Medication and Medication Records were review for proper storage and system implementation.

Garage: There is an underground garage. Facility also offers valet parking.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit.
Exit interview conducted and a copy of this report issued.
NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Michael Cava
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
LIC809 (FAS) - (06/04)
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