NOVA HOUSE, INC.
ICF/DD-H (Habilitative) · 6 licensed beds · San Rafael, CA
Homes of 4–15 beds for people with developmental disabilities whose nursing needs are intermittent and predictable.
Address
NOVA HOUSE, INC.393 NOVA ALBION WAYSan Rafael, CA 94903 · Marin CountyPhone: (415) 686-9643
State penalties
0
none on record since 1998
Federal surveys
13
since 2018 · 8 with deficiencies
Federal deficiencies
50
none condition-level
Last federal survey
Oct 29, 2024
survey date
Facility details
- Facility type
- ICF/DD-H (Habilitative)
- Licensed beds
- 6
- Licensee
- LIFEHOUSE, INC. · Nonprofit Corp
- Administrator
- AGUILAR, ANNE
- CDPH facility ID
- 010001033
- License number
- 010000408
- First licensed
- June 18, 1992
- Current license
- Dec 18, 2025 to Dec 17, 2026
- CDPH district office
- Santa Rosa
Federal certification (CMS)
- CMS Certification Number (CCN)
- 05G789
- Status in CDPH's listing
- Licensed And Certified
- Program
- Medi-Cal (Medicaid, Title XIX)
- Participating since
- December 14, 1993
- Last certification survey
- October 17, 2024
- 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 0.15 · LVN/LPN 0 · direct care 7.25 · all employees 7.4
State citations and penalties (CDPH)
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
No state citations or penalties on record for this facility in CDPH's enforcement data (July 1998 to date).
Federal inspections (CMS-2567)
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").
· Complaint
Event D5BT11 · no deficiencies cited
· Complaint
Event 4C2411 · no deficiencies cited
· Complaint
Event H5NY11 · no deficiencies cited
· Focused Infection Control, Other-Fed
Event 55H911 · no deficiencies cited
· Complaint
Event 10WP11 · no deficiencies cited
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
14 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.
ReportFederal survey (recertification): 3 deficiencies(state record)
ReportFederal survey (complaint, recertification): 3 deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (recertification): 5 deficiencies(state record)
ReportFederal survey (complaint, recertification): 5 deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (focused infection control, other-fed): no deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (recertification): 14 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.