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

CASA #1

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

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

Address

CASA #11372 N 2ND AVEUpland, CA 91786 · San Bernardino County

Phone: (909) 946-7242

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
CASA HEALTH CARE, INC. · Profit Corp
Administrator
RAMIREZ, ROSA
CDPH facility ID
240001684
License number
240000730
First licensed
June 30, 1998
Current license
Nov 22, 2025 to Nov 21, 2026
CDPH district office
San Bernardino

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G214
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
September 10, 1998
Last certification survey
November 4, 2025
CMS certification status
Certified
In compliance (CMS)
No
Last certification action
Complaint
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.22 · LVN/LPN 1.4 · direct care 5.6 · all employees 7.58

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)

23 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 3C5F6F-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event 25D82F-H1 · 3 deficiencies (1 condition-level)

    Official 2567 ↗
  3. · Complaint

    Event 28557F-H1 · no deficiencies cited

    Official 2567 ↗
  4. · Recertification

    Event VNCL21 · 1 deficiency

    Official 2567 ↗
  5. · Recertification

    Event VNCL11 · no deficiencies cited

    Official 2567 ↗
  6. · Recertification

    Event 319E21 · 7 deficiencies

    Official 2567 ↗
  7. · Recertification

    Event 319E11 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event SOZH11 · no deficiencies cited

    Official 2567 ↗
  9. · Recertification

    Event AP3R21 · 5 deficiencies

    Official 2567 ↗
  10. · Recertification

    Event AP3R11 · 2 deficiencies

    Official 2567 ↗
  11. · Recertification

    Event 46Y321 · 4 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event 46Y311 · 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

24 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): 3 deficiencies, 1 condition-level(state record)

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

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

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

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

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

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

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

  10. ReportFederal survey (recertification): 2 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.