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

VAN BUREN HOME

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

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

Address

VAN BUREN HOME22840 VAN BUREN STREETGrand Terrace, CA 92313 · San Bernardino County

Phone: (916) 392-5207

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
ALTERNATIVE CHOICES, INC. · Profit Corp
Administrator
LEONARD, JOHNATHAN
CDPH facility ID
240000969
License number
240000413
First licensed
April 29, 1991
Current license
Apr 1, 2026 to Mar 31, 2027
CDPH district office
San Bernardino

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G533
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
August 17, 1991
Last certification survey
February 4, 2026
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (non-profit)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 1 · direct care 4.25 · all employees 6.25

State citations and penalties (CDPH)

3 penalties, 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 Sep 29, 2009 · Penalty #240008295 · Survey CPNZ11

    Status: Closed · Appealed (received Jun 22, 2011)

    $500

    initially $1,000

  • Class BStaffing

    Citation B (HSC 1424) · Violation Feb 12, 2005 · Penalty #240001864

    Status: Closed · Not appealed

    $1,000

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Aug 27, 2003 · Penalty #240001789

    Status: Closed · Appealed (received Jan 27, 2004)

    $700

Federal inspections (CMS-2567)

28 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 JTQQ21 · 1 deficiency

    Official 2567 ↗
  2. · Recertification

    Event JTQQ11 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event GL1S21 · 3 deficiencies

    Official 2567 ↗
  4. · Recertification

    Event GL1S11 · no deficiencies cited

    Official 2567 ↗
  5. · Recertification

    Event F8BM21 · 3 deficiencies

    Official 2567 ↗
  6. · Recertification

    Event F8BM11 · 4 deficiencies

    Official 2567 ↗
  7. · Complaint

    Event P7FP11 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event JE7711 · no deficiencies cited

    Official 2567 ↗
  9. · Complaint

    Event QJMH11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event C27R11 · no deficiencies cited

    Official 2567 ↗
  11. · Complaint

    Event 7UR311 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event SH5S11 · 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

32 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): no deficiencies(state record)

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

  4. ReportFederal survey (recertification): no deficiencies(state record)

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

  6. ReportFederal survey (recertification): 4 deficiencies(state record)

  7. ReportFederal survey (complaint): 1 deficiency(state record)

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

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

  10. ReportFederal survey (complaint): no deficiencies(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.