MOUNTAIN SHADOWS COMMUNITY HOMES - TANGELO

Facility type

ICF/DD-H (Habilitative)

Licensed beds

6

Licensee

MOUNTAIN SHADOWS SUPPORT GROUP · Nonprofit (state label: Nonprofit Corp)

Administrator

ENCISO, DANIEL

IDs

CDPH facility ID 090000315 · License #090000270 · Federal ID (CCN) 05G257

Current license

Dec 9, 2025 to Dec 8, 2026

CDPH district office

San Diego

Status in CDPH's listing

Licensed And Certified

Pays through

Medi-Cal

Participating since

December 15, 1986

Last certification inspection

January 15, 2025From CMS's Provider of Services file, which can lag behind the inspections listed below.

CMS certification status

Certified

Meets federal requirements (CMS)

Yes

Last CMS certification step

Recertification

Ownership type (CMS)

Private (non-profit)

Certified beds (CMS)

6

Staffing reported to CMS (full-time equivalents)

RN 0.15 · LVN/LPN 0.8 · direct care 6.3 · all employees 6.81Staff hours counted as full-time jobs: 1 is one full-time job; 0.25 is about 10 hours a week.

CDPH's citations come in three classes: AA (a substantial factor in a resident's death), A (imminent danger or a substantial probability of death or serious harm) and B (a direct relationship to residents' health, safety or security). Care homes licensed by Social Services use Type A/B instead: a different agency and scale. State citations explained

• Sep 14, 2023

  Class BPatient CareAbout the care residents received.Death-related

  Rules cited: T22 DIV5 CH8 ART3-76345(a)(6) · Violation Jan 30, 2022 · Penalty #100019161 · Inspection ID WCZU11

  Case closed · Not appealed

  $3,000

  Citation document ↗
• Jul 1, 2005

  Class BStaffingAbout staffing.

  Violation Jun 8, 2005 · Penalty #090002854

  Case closed · Not appealed

  $750

CDPH inspects Medi-Cal certified ICFs for CMS (the federal agency calls these "surveys"). Each finding has a code: W for a care or rights rule, E for emergency preparedness, K for fire safety. A "condition-level" finding is the most serious kind: a whole area of care failed. 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. Mar 2, 2026 · Routine inspection (recertification)

   1 problem found · Inspection ID D40I21

   • KS363Hallway doors(CMS: Corridor - Doors)

   Official federal report ↗Read findings

2. Feb 25, 2026 · Routine inspection (recertification)

   5 problems found · Inspection ID D40I11

   • W128Protecting residents' rights(CMS: Protection Of Clients Rights)
   • W338Nursing care(CMS: Nursing Services)
   • W381Storing medications and keeping records(CMS: Drug Storage And Recordkeeping)
   • W388Medication labels(CMS: Drug Labeling)
   • W389Medication labels(CMS: Drug Labeling)

   Official federal report ↗Read findings

3. Jan 21, 2025 · Routine inspection (recertification)

   no problems found · Inspection ID CV5X21

   Official federal report ↗Read inspection note

4. Jan 15, 2025 · Routine inspection (recertification)

   6 problems found · Inspection ID CV5X11

   • W323Doctor's care (physician services)(CMS: Physician Services)
   • W381Storing medications and keeping records(CMS: Drug Storage And Recordkeeping)
   • W386Storing medications and keeping records(CMS: Drug Storage And Recordkeeping)
   • W388Medication labels(CMS: Drug Labeling)
   • W389Medication labels(CMS: Drug Labeling)
   • W466Food and nutrition(CMS: Food And Nutrition Services)

   Official federal report ↗Read findings

5. Dec 27, 2024 · Complaint inspection

   no problems found · Inspection ID OZ7L11

   Official federal report ↗Read inspection note

6. Jul 30, 2024 · Complaint inspection

   no problems found · Inspection ID S9GK11

   Official federal report ↗Read inspection note

7. Feb 7, 2024 · Routine inspection (recertification)

   1 problem found · Inspection ID 4CN321

   • KS343Fire alarm notification(CMS: Fire Alarm System - Notification)

   Official federal report ↗Read findings

8. Jan 31, 2024 · Routine inspection (recertification)

   6 problems found · Inspection ID 4CN311

   • W325Doctor's care (physician services)(CMS: Physician Services)
   • W327Doctor's care (physician services)(CMS: Physician Services)
   • W386Storing medications and keeping records(CMS: Drug Storage And Recordkeeping)
   • W389Medication labels(CMS: Drug Labeling)
   • W454Infection control(CMS: Infection Control)
   • W460Food and nutrition(CMS: Food And Nutrition Services)

   Official federal report ↗Read findings

9. Sep 25, 2023 · Complaint inspection

   no problems found · Inspection ID XH2T11

   Official federal report ↗Read inspection note

10. Aug 10, 2023 · Complaint inspection

    1 problem found · Inspection ID WCZU11

    • W285Handling residents' challenging behavior(CMS: Mgmt Of Inappropriate Client Behavior)

    Official federal report ↗Read findings

11. Apr 19, 2023 · Complaint inspection

    1 problem found · Inspection ID 592I11

    • W368Giving medications(CMS: Drug Administration)

    Official federal report ↗Read findings

12. Jan 5, 2023 · Complaint inspection

    1 problem found · Inspection ID DONH11

    • W368Giving medications(CMS: Drug Administration)

    Official federal report ↗Read findings

From CMS's inspection data, saved Oct 26, 2026; data after March 19, 2026 may be incomplete while CMS's systems migrate. Plans of correction and State-only (licensing) findings aren't in CMS's file; the official federal reports (form CMS-2567) on CalHealthFind have them.