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

MANZANITA HOME

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

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

Address

MANZANITA HOME708 MANZANITA CTOntario, CA 91762 · San Bernardino County

Phone: (909) 720-9222

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-H (Habilitative)
Licensed beds
6
Licensee
SALEM CHRISTIAN HOMES, INC. · Nonprofit Corp
Administrator
TRUJILLO, KELLY
CDPH facility ID
240001712
License number
240000745
First licensed
December 30, 1999
Current license
Dec 30, 2025 to Dec 29, 2026
CDPH district office
San Bernardino

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G317
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
March 2, 2000
Last certification survey
October 8, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership change (CMS)
April 8, 2010
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.02 · LVN/LPN 0 · direct care 0.09 · all employees 0.11

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)

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. · Complaint

    Event W85I11 · 1 deficiency

    Official 2567 ↗
  2. · Complaint

    Event NTWQ11 · no deficiencies cited

    Official 2567 ↗
  3. · Complaint

    Event JUPG11 · no deficiencies cited

    Official 2567 ↗
  4. · Complaint

    Event DHVF11 · 1 deficiency

    Official 2567 ↗
  5. · Recertification

    Event UQ4A21 · 7 deficiencies

    Official 2567 ↗
  6. · Recertification

    Event UQ4A11 · 1 deficiency

    Official 2567 ↗
  7. · Complaint

    Event 1G2H11 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event P7YO11 · no deficiencies cited

    Official 2567 ↗
  9. · Complaint

    Event X4OG11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event MGER11 · no deficiencies cited

    Official 2567 ↗
  11. · Recertification

    Event U0RI21 · 9 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event U0RI11 · 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

29 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): 1 deficiency(state record)

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

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

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

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

  6. ReportFederal survey (recertification): 1 deficiency(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.