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

CIRCLE OF CARE ICF/DD-N

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

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

Address

CIRCLE OF CARE ICF/DD-N2130 TURNHOUSE LNSan Jose, CA 95121 · Santa Clara County

Phone: (408) 334-7020

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
CIRCLE OF CARE CORPORATION · Profit Corp
Administrator
SAA-ILUSORIO, MARIA V
CDPH facility ID
630010977
License number
550000569
First licensed
August 31, 2007
Current license
Mar 1, 2026 to Feb 28, 2027
CDPH district office
San Jose

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G604
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
August 15, 2008
Last certification survey
August 13, 2025
CMS certification status
Certified
In compliance (CMS)
No
Last certification action
Recertification
Ownership type (CMS)
Other (specify)
Certified beds (CMS)
6
Staffing reported to CMS
RN 1 · LVN/LPN 0 · direct care 4 · all employees 5

State citations and penalties (CDPH)

5 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 · Violations: 483.470(d)(3), W&I 4502(a), W&I 4502(b)(8), 483.470, 483.470(a)(1) · Violation Aug 7, 2025 · Penalty #070022281 · Survey 059D11

    Status: Closed

  • Class BPatient Care

    Citation - B · Violations: 483.410(a), W&I 4502(a), W&I 4502(b)(1), W&I 4502(b)(8), 483.410(e), 483.410(a)(1) · Violation Dec 23, 2024 · Penalty #070022298 · Survey 059D11

    Status: Closed

  • Class AAPatient Care

    Citation - AA · Violations: W&I 4502(a), W&I 4502(b)(4) · Violation Nov 10, 2024 · Penalty #070021101 · Survey HDYM11

    Status: Closed · Appealed (received Jun 20, 2025)

    $25,650

    initially $25,000

    Citation document ↗
  • Class BAbuse/Facility Not Self Reported

    Citation - B · Violations: 483.12(c)(1)(4), 15630(b)(1)(a)(1), 15630(b)(1)(a)(2) · Violation Jun 25, 2024 · Penalty #070020423 · Survey GHM511

    Status: Closed

    $3,800

    initially $2,000

    Citation document ↗
  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Jul 24, 2017 · Penalty #070013622 · Survey DJ2N11

    Status: Closed · Not appealed

    $1,000

Federal inspections (CMS-2567)

17 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 059D21 · 4 deficiencies

    Official 2567 ↗
  2. · Recertification

    Event 059D11 · 27 deficiencies (2 condition-level)

    Official 2567 ↗
  3. · Complaint

    Event HDYM11 · 2 deficiencies (1 condition-level)

    Official 2567 ↗
  4. · Recertification

    Event GHM521 · 7 deficiencies

    Official 2567 ↗
  5. · Complaint, Recertification

    Event GHM511 · 15 deficiencies

    Official 2567 ↗
  6. · Recertification

    Event DG2U21 · 4 deficiencies

    Official 2567 ↗
  7. · Recertification

    Event DG2U11 · 9 deficiencies

    Official 2567 ↗
  8. · Complaint

    Event 4TNZ11 · no deficiencies cited

    Official 2567 ↗
  9. · Focused Infection Control, Other-Fed

    Event 9QTV11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event EGHO11 · 1 deficiency

    Official 2567 ↗
  11. · Recertification

    Event 5A5E21 · 3 deficiencies

    Official 2567 ↗
  12. · Recertification

    Event 5A5E11 · 10 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

23 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. ReportState Class B citation ($1,000)(state record)

    See this citation →
  2. ReportState Class B citation ($1,000)(state record)

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

    See this survey →
  4. ReportFederal survey (recertification): 27 deficiencies, 2 condition-level(state record)

    See this survey →
  5. ReportState Class AA citation ($25,650)(state record)

    See this citation →
  6. ReportFederal survey (complaint): 2 deficiencies, 1 condition-level(state record)

    See this survey →
  7. ReportState Class B citation ($3,800)(state record)

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

    See this survey →
  9. ReportFederal survey (complaint, recertification): 15 deficiencies(state record)

    See this survey →
  10. ReportFederal survey (recertification): 4 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.