S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ASC deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 05C0001910 Alicia Surgery Center, Llc 25211 Paseo De Alicia, Suite 100 Laguna Hills CA 9 (San Francisco) 08/09/2019 7NCY11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001921 Disc Surgery Center At Thousand Oaks 1120 Newbury Road, Suite #100 Thousand Oaks CA 9 (San Francisco) 10/16/2020 22E911 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0100 ENVIRONMENT Condition
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 05C0001931 County Of Los Angeles - High Desert Health System 335 East Avenue I, Suite 229 Lancaster CA 9 (San Francisco) 07/22/2022 4F137-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
▼ 05C0001931 County Of Los Angeles - High Desert Health System 335 East Avenue I, Suite 229 Lancaster CA 9 (San Francisco) 10/22/2018 256121 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
K0131 Multiple Occupancies Standard
K0223 Doors with Self-Closing Devices Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0521 HVAC Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001931 County Of Los Angeles - High Desert Health System 335 East Avenue I, Suite 229 Lancaster CA 9 (San Francisco) 08/02/2018 256111 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0001938 Visalia Children's Dental Surgery Center, Inc 136 Aspen Court, Suite A Visalia CA 9 (San Francisco) 04/18/2024 62B7B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0266 DISCHARGE - ORDER Standard
▼ 05C0001938 Visalia Children's Dental Surgery Center, Inc 136 Aspen Court, Suite A Visalia CA 9 (San Francisco) 01/04/2024 61D40-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0001953 Ucsd Surgical Center Of San Diego Llc 4910 Directors Place, Suite 100 San Diego CA 9 (San Francisco) 05/10/2018 VJFM21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
E0036 EP Training and Testing Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001953 Ucsd Surgical Center Of San Diego Llc 4910 Directors Place, Suite 100 San Diego CA 9 (San Francisco) 03/21/2018 VJFM11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
▼ 05C0001956 Odyssey Asc Endoscopy Center 22 Odyssey, Suite 175 Irvine CA 9 (San Francisco) 02/21/2018 5P3211 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0100 ENVIRONMENT Condition
Q0140 NURSING SERVICES Condition
Q0160 MEDICAL RECORDS Condition
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0260 PATIENT ADMISSION, ASSESSMENT AND DISCHARGE Condition
Q0002 DEFINITIONS Standard
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0161 ORGANIZATION Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0184 VERBAL ORDERS Standard
Q0201 LABORATORY SERVICES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard