DOUGLASS HOME
ICF/DD-N (Nursing) · 6 licensed beds · Pomona, CA
Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.
Address
DOUGLASS HOME1408 DOUGLASS DRPomona, CA 91768 · Los Angeles CountyPhone: (909) 397-5824
State penalties
9
Class 3 A · 5 B
Federal surveys
40
since 2018 · 22 with deficiencies
Federal deficiencies
56
4 condition-level
Last federal survey
Jun 11, 2026
survey date
Facility details
- Facility type
- ICF/DD-N (Nursing)
- Licensed beds
- 6
- Licensee
- RSCR CALIFORNIA, INC. · Profit Corp
- Administrator
- CARREON, YADIRA
- CDPH facility ID
- 960002322
- License number
- 960001073
- First licensed
- May 4, 1999
- Current license
- May 4, 2026 to May 3, 2027
- CDPH district office
- La Icf/Dd/Clinics
Federal certification (CMS)
- CMS Certification Number (CCN)
- 55G284
- Status in CDPH's listing
- Licensed And Certified
- Program
- Medi-Cal (Medicaid, Title XIX)
- Participating since
- August 19, 1999
- Last certification survey
- December 31, 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 0.65 · LVN/LPN 1.6 · direct care 4.8 · all employees 7.05
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
Other penaltyWillful Material Falsification
Violations: 483.410(c)(1), 1424.5.(a) · Violation Jan 16, 2026 · Penalty #960023352 · Survey 88WA11
Status: Closed
$3,500
Citation document ↗Class BPatient Care
Citation - B · Violations: HSC 1275.3(d), HSC 1275.3(a), HSC 1275.3(b) · Violation Jan 16, 2026 · Penalty #960023353 · Survey 88WA11
Status: Closed
$2,000
Citation document ↗Class APatient Care
Citation A (HSC 1424) · Violation Feb 7, 2018 · Penalty #960014357 · Survey 4KW411
Status: Closed · Not appealed
$10,000
Class APatient Care
Citation A (HSC 1424) · Violation Jul 26, 2013 · Penalty #960014054 · Survey MI7D11
Status: Closed · Not appealed
$10,000
Class APatient Care
Citation A (HSC 1424) · Violation Oct 5, 2016 · Penalty #960012908 · Survey KR5011
Status: Closed · Not appealed
$3,500
Class BPatient Care
Citation B (HSC 1424) · Violation Jul 9, 2007 · Penalty #960004223 · Survey MO1911
Status: Closed · Appealed (received Sep 4, 2007)
$500
initially $1,000
Class BPatient Care
Citation B (HSC 1424) · Violation Jun 13, 2005 · Penalty #960001150
Status: Closed · Not appealed
$1,000
Class BPatient Rights
Citation B (HSC 1424) · Violation Sep 23, 2002 · Penalty #960000997
Status: Closed · Not appealed
$500
Class BPatient Rights
Citation B (HSC 1424) · Violation Apr 19, 2000 · Penalty #960000851
Status: Closed · Appealed (received May 16, 2000)
$700
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 TGDX11 · no deficiencies cited
· Recertification
Event 0CG611 · no deficiencies cited
· Complaint
Event QZQK11 · no deficiencies cited
· Complaint
Event FG7E11 · no deficiencies cited
· Complaint
Event PKUK11 · no deficiencies cited
· Recertification
Event 31PS11 · no deficiencies cited
· Complaint
Event KJ2Z11 · 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
50 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 (complaint): 1 deficiency(state record)
ReportState penalty ($3,500)(state record)
ReportState Class B citation ($2,000)(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (complaint): 4 deficiencies, 1 condition-level(state record)
ReportFederal survey (recertification): 1 deficiency(state record)
ReportFederal survey (recertification): no deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (complaint): no deficiencies(state record)
ReportFederal survey (complaint): no 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.