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

MAVIS DIVISION

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

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

Address

MAVIS DIVISION22130 MAVIS STGrand Terrace, CA 92313 · San Bernardino County

Phone: (909) 370-3425

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
JONBEC CARE INCORPORATED · Profit Corp
Administrator
VELA, MAXIMO
CDPH facility ID
240001092
License number
240000469
First licensed
October 13, 1992
Current license
Dec 1, 2025 to Nov 30, 2026
CDPH district office
San Bernardino

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G622
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
October 26, 1992
Last certification survey
April 15, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.15 · LVN/LPN 0 · direct care 7.46 · all employees 7

State citations and penalties (CDPH)

2 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 Rights

    Citation B (HSC 1424) · Violation Jan 2, 2005 · Penalty #240001861

    Status: Closed · Not appealed

    $1,000

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Feb 3, 2003 · Penalty #240001778

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

29 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. · Complaint

    Event 2855CE-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event 231BBB-H1 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event 25CBA2-L1 · 2 deficiencies

    Official 2567 ↗
  4. · Recertification

    Event 25CBA2-H1 · 4 deficiencies

    Official 2567 ↗
  5. · Complaint

    Event 22E460-H1 · no deficiencies cited

    Official 2567 ↗
  6. · Complaint

    Event QSS711 · 1 deficiency

    Official 2567 ↗
  7. · Recertification

    Event M3D221 · 5 deficiencies

    Official 2567 ↗
  8. · Recertification

    Event M3D211 · no deficiencies cited

    Official 2567 ↗
  9. · Recertification

    Event 876521 · 2 deficiencies

    Official 2567 ↗
  10. · Recertification

    Event 876511 · 1 deficiency

    Official 2567 ↗
  11. · Complaint

    Event 5E6P11 · no deficiencies cited

    Official 2567 ↗
  12. · Recertification

    Event N6UY21 · 2 deficiencies

    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 (complaint): no deficiencies(state record)

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

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

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

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

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

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

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

  9. ReportFederal survey (recertification): 2 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.