SHINRAI-GRIDLEY
ICF/DD-N (Nursing) · 6 licensed beds · San Jose, CA
Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.
Address
SHINRAI-GRIDLEY394 GRIDLEY STSan Jose, CA 95127 · Santa Clara CountyPhone: (408) 729-5717
State penalties
10
Class 10 B
Federal surveys
30
since 2018 · 16 with deficiencies
Federal deficiencies
93
1 condition-level
Last federal survey
Jun 16, 2026
survey date
Facility details
- Facility type
- ICF/DD-N (Nursing)
- Licensed beds
- 6
- Licensee
- MOURI MANAGEMENT GROUP INCORPORATED · Profit Corp
- Administrator
- BONUAN, MARIA ANGELICA S
- CDPH facility ID
- 070001025
- License number
- 070000439
- First licensed
- February 25, 1998
- Current license
- Feb 25, 2026 to Feb 24, 2027
- CDPH district office
- San Jose
Federal certification (CMS)
- CMS Certification Number (CCN)
- 55G373
- Status in CDPH's listing
- Licensed And Certified
- Program
- Medi-Cal (Medicaid, Title XIX)
- Participating since
- January 23, 2001
- Last certification survey
- September 12, 2025
- CMS certification status
- Certified
- In compliance (CMS)
- No
- Last certification action
- Recertification
- Ownership type (CMS)
- Private (proprietary)
- Certified beds (CMS)
- 6
- Staffing reported to CMS
- RN 1 · LVN/LPN 3.25 · direct care 13.5 · all employees 17.75
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
Class BPatient Care
Citation - B · Violations: 483.450(b)(2), W&I 4502(b)(8) · Violation Aug 2, 2025 · Penalty #070022628 · Survey IK4811
Status: Closed
$1,000
Citation document ↗Class BOther
Citation - B · Violations: 483.470(l)(1), T22 DIV5 CH4 ART4-73539 · Violation May 19, 2024 · Penalty #070020226 · Survey 43O411
Status: Closed · Not appealed
$3,000
Citation document ↗Class BAdministration
Citation B (HSC 1424) · Violation Jun 15, 2018 · Penalty #070014497 · Survey 9FXH11
Status: Closed · Not appealed
$1,000
Class BPatient Rights
Citation B (HSC 1424) · Violation Jan 26, 2016 · Penalty #070012020 · Survey YXYL11
Status: Closed · Not appealed
$500
Class BPatient Care
Citation B (HSC 1424) · Violation May 7, 2011 · Penalty #070008349 · Survey IFRX11
Status: Closed · Not appealed
$600
Class BPatient Rights
Citation B (HSC 1424) · Violation Feb 1, 2011 · Penalty #070007952 · Survey YZRH11
Status: Closed · Not appealed
$500
Class BPatient Rights
Citation B (HSC 1424) · Violation Feb 22, 2007 · Penalty #070003803 · Survey PAY011
Status: Closed · Not appealed
$1,000
Class BPatient Rights
Citation B (HSC 1424) · Violation Sep 24, 2003 · Penalty #070002549
Status: Closed · Not appealed
$600
Class BPatient Care
Citation B (HSC 1424) · Violation Feb 24, 2003 · Penalty #070002505
Status: Closed · Not appealed
$600
Class BAdministration
Citation B (HSC 1424) · Violation Nov 13, 2002 · Penalty #070002482
Status: Closed · Not appealed
$1,000
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 236012-H1 · no deficiencies cited
· Complaint
Event 64DB11 · no deficiencies cited
· Complaint
Event 7OIZ11 · no deficiencies cited
· Complaint
Event 8YZ811 · 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
41 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): no deficiencies(state record)
See this survey →ReportFederal survey (complaint): 1 deficiency(state record)
See this survey →ReportFederal survey (complaint): no deficiencies(state record)
See this survey →ReportState Class B citation ($1,000)(state record)
See this citation →ReportFederal survey (recertification): 5 deficiencies(state record)
See this survey →ReportFederal survey (complaint, recertification): 24 deficiencies, 1 condition-level(state record)
See this survey →ReportFederal survey (complaint): 2 deficiencies(state record)
See this survey →ReportState Class B citation ($3,000)(state record)
See this citation →ReportFederal survey (recertification): 5 deficiencies(state record)
See this survey →ReportFederal survey (complaint, recertification): 10 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.