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

JACKIE LEE AND JIM HOUSTON HOUSE

ICF/DD-N (Nursing) · 6 licensed beds · Desert Hot Springs, CA

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

Address

JACKIE LEE AND JIM HOUSTON HOUSE66415 BUENA VISTA AVEDesert Hot Springs, CA 92240 · Riverside County

Phone: (760) 834-1303

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
ANGEL VIEW, INC. · Nonprofit Corp
Administrator
BERDEJO, KARINNA
CDPH facility ID
630012729
License number
550001426
First licensed
November 18, 2010
Current license
Nov 18, 2025 to Nov 17, 2026
CDPH district office
Riverside

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G667
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
April 7, 2011
Last certification survey
December 2, 2025
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 0.25 · LVN/LPN 3 · direct care 6 · all employees 9.25

State citations and penalties (CDPH)

1 penalty, 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 Mar 10, 2017 · Penalty #250013676 · Survey 09JH11

    Status: Closed · Not appealed

    $2,000

Federal inspections (CMS-2567)

43 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 2340AC-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event 22FEB6-H1 · no deficiencies cited

    Official 2567 ↗
  3. · Complaint

    Event 22CD5D-H1 · no deficiencies cited

    Official 2567 ↗
  4. · Complaint

    Event JOZO11 · no deficiencies cited

    Official 2567 ↗
  5. · Complaint

    Event 2KOD11 · no deficiencies cited

    Official 2567 ↗
  6. · Recertification

    Event QEGH21 · 1 deficiency

    Official 2567 ↗
  7. · Complaint, Recertification

    Event QEGH11 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event CHS011 · no deficiencies cited

    Official 2567 ↗
  9. · Complaint

    Event CTDU11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event TER311 · no deficiencies cited

    Official 2567 ↗
  11. · Complaint

    Event H4PN11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event TC3T11 · 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

45 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)

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

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

    See this survey →
  4. ReportFederal survey (complaint): no deficiencies(state record)

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

    See this survey →
  6. ReportFederal survey (recertification): 1 deficiency(state record)

    See this survey →
  7. ReportFederal survey (complaint, recertification): 1 deficiency(state record)

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

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

    See this survey →
  10. ReportFederal survey (complaint): no 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.