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
▼ 05C0002010 Ps Center, Llc 1640 Newport Blvd, Suite 100 Costa Mesa CA 9 (San Francisco) 09/05/2018 PFT411 Complaint, Sample Validation
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
Q0201 LABORATORY SERVICES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0002014 Riverwalk Surgery Center 4244 Riverwalk Parkway, Suite 210 Riverside CA 9 (San Francisco) 02/06/2020 YS7121 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 05C0002014 Riverwalk Surgery Center 4244 Riverwalk Parkway, Suite 210 Riverside CA 9 (San Francisco) 01/23/2020 YS7111 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 05C0002015 Soma Surgery Center 8929 Wilshire Blvd, Suite 102 Beverly Hills CA 9 (San Francisco) 02/25/2022 HYN411 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0240 INFECTION CONTROL Condition
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 05C0002021 Inland Valley Surgery Center 41900 Winchester Road, Suite 102 Temecula CA 9 (San Francisco) 06/13/2019 OSD521 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0002021 Inland Valley Surgery Center 41900 Winchester Road, Suite 102 Temecula CA 9 (San Francisco) 06/12/2019 OSD511 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0122 REAPPRAISALS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0002023 Martel Eye Institute, Llc 11216 Trinity River Drive Rancho Cordova CA 9 (San Francisco) 05/05/2025 658BD-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0039 EP Testing Requirements Standard
K0291 Emergency Lighting Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0002023 Martel Eye Institute, Llc 11216 Trinity River Drive Rancho Cordova CA 9 (San Francisco) 05/01/2025 658BD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0122 REAPPRAISALS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0002030 Risser Surgery Center Llc 2615 E Washington Blvd Pasadena CA 9 (San Francisco) 10/11/2019 5NG711 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0041 CONTRACT SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0204 RADIOLOGIC SERVICES Standard
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
▼ 05C0002036 Lags Surgery Center Fresno 5771 N Fresno St Ste 101 Fresno CA 9 (San Francisco) 07/09/2018 I8BJ21 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
E0036 EP Training and Testing Standard
K0131 Multiple Occupancies Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
K0912 Electrical Systems - Receptacles Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard