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ICF/DD-H (Habilitative)License activeMedi-Cal certified

BUTLER VALLEY #2

ICF/DD-H (Habilitative) · 6 licensed beds · Eureka, CA

Homes of 4–15 beds for people with developmental disabilities whose nursing needs are intermittent and predictable.

Address

BUTLER VALLEY #23971 F STEureka, CA 95503 · Humboldt County

Phone: (707) 442-7313

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
BUTLER VALLEY INC. · Nonprofit Corp
Administrator
OTT, SUZETTE M
CDPH facility ID
010000088
License number
010000137
First licensed
November 1, 1985
Current license
Dec 1, 2025 to Nov 30, 2026
CDPH district office
Santa Rosa

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G154
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
October 17, 1985
Last certification survey
October 22, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (non-profit)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.26 · LVN/LPN 0 · direct care 10.15 · all employees 10.41

State citations and penalties (CDPH)

6 penalties, newest first

CDPH issues citations under Health and Safety Code §1424: Class AA (a violation that was a substantial factor in a resident's death), Class A (imminent danger or a substantial probability of death or serious harm) and Class B (a direct relationship to residents' health, safety or security). State citations explained

  • Class BPatient Record

    Citation - B · Violations: HSC Section 1439.6(a), HSC Section 1439.6(E)(1)(2)(A)(B)(C), HSC Section 1439.6(f), HSC Section 1439.6(c) · Violation Jan 13, 2026 · Penalty #110023361 · Survey DU4B11

    Status: Closed

  • Class AAPatient Care

    Citation - AA · Violations: T22 DIV5 CH8.5 ART3-76878(a) · Violation Aug 26, 2022 · Penalty #110023029 · Survey CXUV11

    Status: Closed

  • Class APatient Care

    Citation - A · Violations: T22 DIV5 CH8.5 ART3-76865(m), T22 DIV5 CH8.5 ART3-76875(a)(2) · Violation Feb 14, 2022 · Penalty #110023030 · Survey WJPN11

    Status: Closed

  • Class APatient Rights

    Citation - A · Violations: 483.420(a)(5), T22 DIV5 CH8.5 ART3-76858(b)(1), T22 DIV5 CH8.5 ART3-76858(b)(2), T22 DIV5 CH8.5 ART3-76858(b)(3), T22 DIV5 CH8.5 ART3-76870 · Violation Jan 2, 2024 · Penalty #110023043 · Survey 7S2511

    Status: Closed

  • Class BPatient Record

    Citation B (HSC 1424) · Violation Feb 1, 2002 – Jul 26, 2002 · Penalty #010001969

    Status: Closed · Not appealed

    $800

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Dec 12, 2001 – Jan 9, 2002 · Penalty #010001920

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

24 surveys since 2018 · CMS data through Oct 12, 2026

CDPH surveys certified ICFs for CMS. Each deficiency is a W-tag (a federal ICF/IID requirement), an E-tag (emergency preparedness) or a K-tag (Life Safety Code), cited at the standard level or, more seriously, the condition level. How to read an ICF inspection

Content note: these federal findings describe residents' care and can include abuse, neglect, injuries and medical details. They're shown as CMS published them; residents are identified only by number (such as "Client 1").

  1. · Recertification

    Event 8XXU21 · 2 deficiencies

    Official 2567 ↗
  2. · Recertification

    Event 8XXU11 · 2 deficiencies

    Official 2567 ↗
  3. · Complaint

    Event P1TM11 · 1 deficiency

    Official 2567 ↗
  4. · Complaint

    Event 4KXV11 · no deficiencies cited

    Official 2567 ↗
  5. · Complaint

    Event 7S2511 · 1 deficiency

    Official 2567 ↗
  6. · Complaint

    Event DR2M11 · no deficiencies cited

    Official 2567 ↗
  7. · Complaint

    Event OWW811 · no deficiencies cited

    Official 2567 ↗
  8. · Complaint

    Event L15K11 · 13 deficiencies (3 condition-level)

    Official 2567 ↗
  9. · Complaint

    Event OKFD11 · 1 deficiency

    Official 2567 ↗
  10. · Complaint

    Event OTQ311 · 2 deficiencies

    Official 2567 ↗
  11. · Complaint

    Event IV4U11 · 5 deficiencies (1 condition-level)

    Official 2567 ↗
  12. · Recertification

    Event QM8Q21 · 2 deficiencies

    Official 2567 ↗

From CMS's QCOR ICF/IID statement-of-deficiency download, saved Oct 26, 2026. CMS notes that ICF/IID data after March 19, 2026 may be incomplete while its systems migrate. Plans of correction and state-only (licensing) deficiencies aren't in that file; the official 2567 documents on CalHealthFind have them.

Complaints and reported incidents

CDPH doesn't publish complaints or facility-reported incidents as a bulk file, so they aren't on ICFLookup. Its CalHealthFind page for this facility lists them (intake date, allegation category and whether each was substantiated), along with state licensing deficiencies and ownership details.

Federal surveys that came from a complaint or an incident report do appear above, marked "Complaint" as the survey type.

Open this facility on CalHealthFind ↗How to file a complaint with CDPH

Change history

31 events, newest first

Dates marked "state record" are the agencies' own: the license date, federal survey dates and penalty issue dates. "Detected" changes are ones we noticed by comparing CDPH's monthly facility listing with the one before it, tracked since Oct 26, 2026.

  1. ReportState Class B citation ($1,000)(state record)

  2. ReportState Class AA citation ($25,000)(state record)

  3. ReportState Class A citation ($20,000)(state record)

  4. ReportState Class A citation ($20,000)(state record)

  5. ReportFederal survey (recertification): 2 deficiencies(state record)

  6. ReportFederal survey (recertification): 2 deficiencies(state record)

  7. ReportFederal survey (complaint): 1 deficiency(state record)

  8. ReportFederal survey (complaint): no deficiencies(state record)

  9. ReportFederal survey (complaint): 1 deficiency(state record)

  10. ReportFederal survey (complaint): no deficiencies(state record)

Sources: CDPH Licensed and Certified Healthcare Facility Listing (data as of Oct 16, 2026), CDPH State Enforcement Actions, and CMS's ICF/IID statement-of-deficiency (CMS-2567) and Provider of Services files. ICFLookup is not affiliated with CDPH or CMS; always confirm with CDPH's CalHealthFind ↗ before making a decision. See How our data works.