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

JACARANDA HOME

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

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

Address

JACARANDA HOME12549 JACARANDA PLChino, CA 91710 · San Bernardino County

Phone: (909) 287-4155

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
HEATH, SARAH T
CDPH facility ID
630013071
License number
550001752
First licensed
September 12, 2011
Current license
Nov 12, 2025 to Nov 11, 2026
CDPH district office
San Bernardino

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
55G681
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
May 4, 2012
Last certification survey
October 22, 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 2 · LVN/LPN 0 · direct care 10 · all employees 12

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)

22 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 341B97-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event CXME11 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event EF6M21 · no deficiencies cited

    Official 2567 ↗
  4. · Recertification

    Event EF6M11 · no deficiencies cited

    Official 2567 ↗
  5. · Complaint

    Event VD8I11 · no deficiencies cited

    Official 2567 ↗
  6. · Recertification

    Event N9XX21 · 2 deficiencies

    Official 2567 ↗
  7. · Recertification

    Event N9XX11 · no deficiencies cited

    Official 2567 ↗
  8. · Complaint

    Event ISHQ11 · 1 deficiency

    Official 2567 ↗
  9. · Complaint

    Event NIUB11 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event 6NV111 · 1 deficiency

    Official 2567 ↗
  11. · Complaint

    Event H8IP11 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event DT5211 · 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

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

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

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

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

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

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

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

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

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

  10. ReportFederal survey (complaint): 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.