Skip to content
ICF/DDLicense activeMedi-Cal certified

HELEN EVANS HOME

ICF/DD · 42 licensed beds · Hacienda Heights, CA

Larger intermediate care facilities for people with developmental disabilities.

Address

HELEN EVANS HOME15125 GALE AVEHacienda Heights, CA 91745 · Los Angeles County

Phone: (626) 330-4048

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD
Licensed beds
42
Licensee
GSM HEALTHCARE SERVICES, LLC · Limited Liability Company
Administrator
OROZCO, HECTOR
CDPH facility ID
960000947
License number
960000515
Current license
May 16, 2026 to May 15, 2027
CDPH district office
La Icf/Dd/Clinics

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G039
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
April 1, 1980
Last certification survey
June 26, 2025
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Other (specify)
Certified beds (CMS)
42
Staffing reported to CMS
RN 1 · LVN/LPN 3 · direct care 9 · all employees 15

State citations and penalties (CDPH)

3 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 APatient Care

    Citation A (HSC 1424) · Violation May 5, 2010 · Penalty #960007734 · Survey B7B211

    Status: Closed · Appealed (received Jan 3, 2011)

    $10,000

  • Class APatient Care

    Citation A (HSC 1424) · Violation Jan 5, 2010 · Penalty #960007255 · Survey V4X411

    Status: Closed · Appealed (received Jul 8, 2010)

    $5,000

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Sep 28, 2001 · Penalty #960000937

    Status: Closed · Not appealed

    $700

Federal inspections (CMS-2567)

134 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 3C60EC-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Complaint

    Event 31C956-H1 · no deficiencies cited

    Official 2567 ↗
  3. · Recertification

    Event 2CFCD2-L1 · 10 deficiencies

    Official 2567 ↗
  4. · Recertification

    Event 2CFCD2-H1 · 2 deficiencies

    Official 2567 ↗
  5. · Complaint

    Event 2CFDF6-H1 · 1 deficiency

    Official 2567 ↗
  6. · Complaint

    Event 2361B4-H1 · no deficiencies cited

    Official 2567 ↗
  7. · Complaint

    Event 233BCA-H1 · 1 deficiency

    Official 2567 ↗
  8. · Complaint

    Event 232FCB-H1 · no deficiencies cited

    Official 2567 ↗
  9. · Complaint

    Event 22F1AC-H1 · no deficiencies cited

    Official 2567 ↗
  10. · Complaint

    Event 22D50B-H1 · no deficiencies cited

    Official 2567 ↗
  11. · Complaint

    Event 22D656-H1 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event YTTM11 · 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

137 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): 10 deficiencies(state record)

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

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

  6. ReportFederal survey (complaint): no deficiencies(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.