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

PETIT COMMUNITY HOME

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

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

Address

PETIT COMMUNITY HOME228 PETIT AVEVentura, CA 93004 · Ventura County

Phone: (805) 659-3683

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
NORMAL LIFE OF CALIFORNIA INC · Profit Corp
Administrator
BRYSON, SHANNON
CDPH facility ID
050000919
License number
050000368
First licensed
November 8, 1993
Current license
Mar 2, 2026 to Mar 1, 2027
CDPH district office
Ventura

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G727
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
January 18, 1994
Last certification survey
February 4, 2026
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Other
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 0 · direct care 8 · all employees 10

State citations and penalties (CDPH)

5 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 BAbuse/Facility Not Self Reported

    Citation B (HSC 1424) · Violation May 12, 2009 · Penalty #050006243 · Survey 9X5S11

    Status: Closed · Appealed (received Apr 27, 2011)

    $300

    initially $600

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Apr 30, 2009 · Penalty #050006244 · Survey QMYV11

    Status: Closed · Appealed (received Apr 27, 2011)

    $500

    initially $1,000

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Sep 11, 2009 · Penalty #050006581 · Survey 52IG11

    Status: Closed · Appealed (received Feb 11, 2010)

    $250

    initially $500

  • Class BAbuse/Facility Not Self Reported

    Citation B (HSC 1424) · Violation Nov 9, 2009 · Penalty #050006871 · Survey G99X11

    Status: Closed · Appealed (received Feb 11, 2010)

    $250

    initially $500

  • Class APatient Care

    Citation A (HSC 1424) · Violation Jun 14, 2008 · Penalty #050005199 · Survey 47WL11

    Status: Closed · Not appealed

    $3,000

Federal inspections (CMS-2567)

32 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. · Complaint

    Event 2F5514-H1 · 1 deficiency

    Official 2567 ↗
  2. · Complaint

    Event 25C8CB-H1 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event NS5521 · no deficiencies cited

    Official 2567 ↗
  4. · Recertification

    Event NS5511 · no deficiencies cited

    Official 2567 ↗
  5. · Complaint

    Event WT5Q11 · no deficiencies cited

    Official 2567 ↗
  6. · Complaint

    Event 9IXN11 · 2 deficiencies

    Official 2567 ↗
  7. · Complaint

    Event U3HU11 · 1 deficiency

    Official 2567 ↗
  8. · Recertification

    Event R4UL21 · 4 deficiencies

    Official 2567 ↗
  9. · Recertification

    Event R4UL11 · 2 deficiencies

    Official 2567 ↗
  10. · Complaint

    Event CEVF11 · 1 deficiency

    Official 2567 ↗
  11. · Recertification

    Event Z0PG21 · 4 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event Z0PG11 · 1 deficiency

    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

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

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

  3. ReportFederal survey (recertification): no deficiencies(state record)

  4. ReportFederal survey (recertification): no deficiencies(state record)

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

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

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

  8. ReportFederal survey (recertification): 4 deficiencies(state record)

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

  10. ReportFederal survey (complaint): 1 deficiency(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.