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ICF/DD-N (Nursing)License activeMedi-Cal certified

AMERICAN STAR HOME 3 ICF/DD-N

ICF/DD-N (Nursing) · 6 licensed beds · Oakley, CA

Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.

Address

AMERICAN STAR HOME 3 ICF/DD-N125 BROWNSTONE ROADOakley, CA 94561 · Contra Costa County

Phone: (925) 625-7354

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
AMERICAN STAR HOME 3 ICF/DD-N · Profit Corp
Administrator
TING, VICKY S
CDPH facility ID
140001322
License number
140000682
First licensed
August 1, 2004
Current license
Jul 11, 2026 to Nov 28, 2026
CDPH district office
East Bay

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G744
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
June 8, 1993
Last certification survey
September 12, 2024
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
CHOW
Ownership change (CMS)
January 15, 2018
Ownership type (CMS)
Other (specify)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1.4 · LVN/LPN 0 · direct care 4.6 · all employees 6.4

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

No state citations or penalties on record for this facility in CDPH's enforcement data (July 1998 to date).

Federal inspections (CMS-2567)

14 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 22BE1B-L1 · 5 deficiencies

    Official 2567 ↗
  2. · Recertification

    Event 22BE1B-H1 · 7 deficiencies

    Official 2567 ↗
  3. · Recertification

    Event GQ9321 · 2 deficiencies

    Official 2567 ↗
  4. · Recertification

    Event GQ9311 · 3 deficiencies

    Official 2567 ↗
  5. · Recertification

    Event DFLQ21 · 5 deficiencies

    Official 2567 ↗
  6. · Recertification

    Event DFLQ11 · 1 deficiency

    Official 2567 ↗
  7. · Complaint

    Event VVJV11 · no deficiencies cited

    Official 2567 ↗
  8. · Recertification

    Event MX0B21 · 5 deficiencies

    Official 2567 ↗
  9. · Complaint

    Event ZJ2511 · no deficiencies cited

    Official 2567 ↗
  10. · Recertification

    Event MX0B11 · 2 deficiencies

    Official 2567 ↗
  11. · Complaint

    Event IUB811 · 2 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event SKQO21 · 1 deficiency

    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

15 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): 5 deficiencies(state record)

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

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

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

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

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

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

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

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

    See this survey →
  10. ReportFederal survey (recertification): 2 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.