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

VALLEY VILLAGE TUPPERHOUSE

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

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

Address

VALLEY VILLAGE TUPPERHOUSE16124 TUPPER STNorth Hills, CA 91343 · Los Angeles County

Phone: (818) 587-9450

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
VALLEY VILLAGE · Nonprofit Corp
Administrator
EFFATIAN, SUSIE
CDPH facility ID
960001771
License number
960000854
First licensed
April 22, 1994
Current license
Apr 22, 2026 to Apr 21, 2027
CDPH district office
La Icf/Dd/Clinics

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G468
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
October 2, 1989
Last certification survey
December 24, 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 0.25 · LVN/LPN 0 · direct care 5 · all employees 5.25

State citations and penalties (CDPH)

2 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 Care

    Citation - B · Violations: T22 DIV5 CH8.5 ART3-76865(m) · Violation Apr 30, 2025 · Penalty #960022212 · Survey MHLZ11

    Status: Closed

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Feb 7, 2001 · Penalty #960000892

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

31 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 31CDDC-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event U1VO11 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event 3FIZ11 · 4 deficiencies

    Official 2567 ↗
  4. · Recertification

    Event 3FIZ21 · 1 deficiency

    Official 2567 ↗
  5. · Complaint

    Event 4UW211 · 1 deficiency

    Official 2567 ↗
  6. · Complaint

    Event MHLZ11 · 1 deficiency

    Official 2567 ↗
  7. · Complaint

    Event 4GWG11 · no deficiencies cited

    Official 2567 ↗
  8. · Recertification

    Event RU2Q21 · 1 deficiency

    Official 2567 ↗
  9. · Recertification

    Event RU2Q11 · 5 deficiencies

    Official 2567 ↗
  10. · Complaint

    Event 4FRT11 · no deficiencies cited

    Official 2567 ↗
  11. · Complaint

    Event NTWD11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event YKFR11 · no deficiencies cited

    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

34 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): no deficiencies(state record)

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

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

    See this survey →
  4. ReportFederal survey (recertification): 1 deficiency(state record)

    See this survey →
  5. ReportFederal survey (complaint): 1 deficiency(state record)

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

    See this citation →
  7. ReportFederal survey (complaint): 1 deficiency(state record)

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

    See this survey →
  9. ReportFederal survey (recertification): 1 deficiency(state record)

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

    See this survey →

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.