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

TLC - DONNA HOUSE

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

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

Address

TLC - DONNA HOUSE9530 DONNA AVENorthridge, CA 91324 · Los Angeles County

Phone: (818) 797-8852

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Administrator
GLOVER, LATOYA M
CDPH facility ID
960002094
License number
960001000
First licensed
January 27, 1997
Current license
Dec 27, 2025 to Dec 26, 2026
CDPH district office
La Icf/Dd/Clinics

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G090
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
April 2, 1997
Last certification survey
March 6, 2025
CMS certification status
Certified
In compliance (CMS)
No
Last certification action
Recertification
Ownership type (CMS)
Private (non-profit)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 1 · direct care 6 · all employees 8

State citations and penalties (CDPH)

3 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 Rights

    Citation - B · Violations: T22 DIV5 CH8.5 ART4-76923(a), W&I 4502(a), W&I 4502(b)(2) · Violation Feb 26, 2026 · Penalty #960023473 · Survey HFF411

    Status: Open

  • Class BWritten Notification Remedy

    Citation - B · Violations: T22 DIV5 CH8.5 ART5-76935 · Violation Aug 1, 2024 · Penalty #960020721 · Survey R1PU11

    Status: Closed

  • Class BAbuse/Facility Not Self Reported

    Citation - B · Violations: T22 DIV5 CH8.5 ART4-76923(a), 483.410(a)(1), T22 DIV5 CH8.5 ART3-76875(a) · Violation Dec 15, 2023 · Penalty #960019975 · Survey 1GNL11

    Status: Closed · Not appealed

    $2,350

    initially $2,000

    Citation document ↗

Federal inspections (CMS-2567)

40 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 236C9D-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Recertification

    Event HFF411 · 13 deficiencies (2 condition-level)

    Official 2567 ↗
  3. · Recertification

    Event HFF421 · 6 deficiencies

    Official 2567 ↗
  4. · Complaint, Recertification

    Event TSCR11 · 4 deficiencies

    Official 2567 ↗
  5. · Recertification

    Event TSCR21 · 2 deficiencies

    Official 2567 ↗
  6. · Complaint

    Event SFLF11 · no deficiencies cited

    Official 2567 ↗
  7. · Complaint

    Event GGTV11 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event R1PU11 · 1 deficiency

    Official 2567 ↗
  9. · Complaint

    Event QYSZ11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event ZHA511 · no deficiencies cited

    Official 2567 ↗
  11. · Recertification

    Event 3U6S21 · 3 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event 3U6S11 · 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

44 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. ReportState Class B citation ($2,000)(state record)

    See this citation →
  3. ReportFederal survey (recertification): 13 deficiencies, 2 condition-level(state record)

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

    See this survey →
  5. ReportFederal survey (complaint, recertification): 4 deficiencies(state record)

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

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

    See this survey →
  8. ReportState Class B citation ($2,500)(state record)

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

    See this survey →
  10. ReportFederal survey (complaint): 1 deficiency(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.