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ICF/DD-N (Nursing)License activeMedi-Cal certified

NORTHRIDGE MANOR

ICF/DD-N (Nursing) · 6 licensed beds · Northridge, CA

Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.

Address

NORTHRIDGE MANOR9501 VANALDEN AVENorthridge, CA 91324 · Los Angeles County

Phone: (818) 626-9823

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
NORTHRIDGE MANOR · Profit Corp
Administrator
AMIRKHANYAN, ARARAT
CDPH facility ID
630026018
License number
550008614
First licensed
June 27, 2023
Current license
Jun 27, 2026 to Jun 26, 2027
CDPH district office
La Icf/Dd/Clinics

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G814
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
September 26, 2024
Last certification survey
August 20, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 2 · direct care 4 · all employees 7

State citations and penalties (CDPH)

1 penalty, 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 BFinancial Occurrence/Fac Not Self Reported

    Citation - B · Violations: 483.420(b)(1)(ii), 483.420(a)(4), 483.420(b)(1)(i), T22 DIV5 CH4 ART4-73557(a)(1), T22 DIV5 CH4 ART4-73557(a)(2) · Violation Jul 1, 2025 · Penalty #960023328 · Survey 47SS11

    Status: Closed

Federal inspections (CMS-2567)

7 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 2CFD7C-L1 · 4 deficiencies

    Official 2567 ↗
  2. · Recertification

    Event 2CFD7C-H1 · 4 deficiencies

    Official 2567 ↗
  3. · Complaint

    Event 5G2011 · no deficiencies cited

    Official 2567 ↗
  4. · Recertification

    Event ETK721 · 2 deficiencies

    Official 2567 ↗
  5. · Recertification

    Event ETK711 · 3 deficiencies

    Official 2567 ↗
  6. · Initial Certification

    Event 7W4R21 · 4 deficiencies

    Official 2567 ↗
  7. · Initial Certification

    Event 7W4R11 · 5 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

9 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 (recertification): 4 deficiencies(state record)

    See this survey →
  2. ReportFederal survey (recertification): 4 deficiencies(state record)

    See this survey →
  3. ReportState Class B citation ($2,000)(state record)

    See this citation →
  4. ReportFederal survey (complaint): no deficiencies(state record)

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

    See this survey →
  6. ReportFederal survey (recertification): 3 deficiencies(state record)

    See this survey →
  7. ReportFederal survey (initial certification): 4 deficiencies(state record)

    See this survey →
  8. ReportFederal survey (initial certification): 5 deficiencies(state record)

    See this survey →
  9. LicensedLicensed(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.