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

MOUNTAIN SHADOWS COMMUNITY HOMES - SPRUCE

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 - SPRUCE2067 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
RICH, JORDAN
CDPH facility ID
090000311
License number
090000269
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)
05G247
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
March 12, 1987
Last certification survey
August 20, 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 BPatient Care

    Citation B (HSC 1424) · Violation Feb 22, 2015 · Penalty #090011414 · Survey 13Y111

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

15 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 944F21 · 1 deficiency

    Official 2567 ↗
  2. · Recertification

    Event 944F11 · 1 deficiency

    Official 2567 ↗
  3. · Complaint

    Event LYWN11 · no deficiencies cited

    Official 2567 ↗
  4. · Recertification

    Event LTBW21 · 1 deficiency

    Official 2567 ↗
  5. · Recertification

    Event LTBW11 · 3 deficiencies

    Official 2567 ↗
  6. · Complaint

    Event 8MUT11 · no deficiencies cited

    Official 2567 ↗
  7. · Recertification

    Event 9SGR21 · 2 deficiencies

    Official 2567 ↗
  8. · Recertification

    Event 9SGR11 · 8 deficiencies

    Official 2567 ↗
  9. · Complaint

    Event 9HUF11 · no deficiencies cited

    Official 2567 ↗
  10. · Recertification

    Event TTSG21 · 1 deficiency

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

    Event V55T11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event IH7411 · 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

16 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)

  2. ReportFederal survey (recertification): 1 deficiency(state record)

  3. ReportFederal survey (complaint): no deficiencies(state record)

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

  5. ReportFederal survey (recertification): 3 deficiencies(state record)

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

  7. ReportFederal survey (recertification): 2 deficiencies(state record)

  8. ReportFederal survey (recertification): 8 deficiencies(state record)

  9. ReportFederal survey (complaint): no deficiencies(state record)

  10. ReportFederal survey (recertification): 1 deficiency(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.