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

MOUNTAIN SHADOWS COMMUNITY HOMES - BIRCH

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

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

Address

MOUNTAIN SHADOWS COMMUNITY HOMES - BIRCH2067 W EL NORTE PKWYEscondido, CA 92026 · San Diego County

Phone: (760) 743-3714

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
MOUNTAIN SHADOWS SUPPORT GROUP · Nonprofit Corp
Administrator
TEDROW, SARAH A
CDPH facility ID
090000278
License number
090000257
First licensed
December 12, 1985
Current license
Dec 9, 2025 to Dec 8, 2026
CDPH district office
San Diego

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G200
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
December 23, 1985
Last certification survey
July 9, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership change (CMS)
October 1, 2002
Ownership type (CMS)
Private (non-profit)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.15 · LVN/LPN 0 · direct care 6.3 · all employees 6.81

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 BPhysical Environment

    Citation - B · Violations: T22 DIV5 CH8.5 ART3-76892(a), T22 DIV5 CH8.5 ART3-76889(b), 483.470 · Violation Jun 19, 2024 · Penalty #100020518 · Survey UWQS11

    Status: Closed

Federal inspections (CMS-2567)

19 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 0LBU11 · 1 deficiency

    Official 2567 ↗
  2. · Recertification

    Event 0LBU21 · 3 deficiencies

    Official 2567 ↗
  3. · Recertification

    Event UWQS21 · 1 deficiency

    Official 2567 ↗
  4. · Recertification

    Event UWQS11 · 5 deficiencies

    Official 2567 ↗
  5. · Complaint

    Event GDWC11 · no deficiencies cited

    Official 2567 ↗
  6. · Complaint

    Event 12CW11 · no deficiencies cited

    Official 2567 ↗
  7. · Recertification

    Event LE5N21 · 2 deficiencies

    Official 2567 ↗
  8. · Recertification

    Event LE5N11 · 3 deficiencies

    Official 2567 ↗
  9. · Focused Infection Control, Other-Fed

    Event E3BC11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event NZ6Y11 · no deficiencies cited

    Official 2567 ↗
  11. · Complaint

    Event 8VUV11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event 9QS311 · 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

21 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): 1 deficiency(state record)

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

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

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

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

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

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

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

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

    See this survey →
  10. ReportFederal survey (focused infection control, other-fed): no 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.