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
▼ 05C0002066 Premier Surgery Center Of Beverly Hills, Llc 99 N La Cienega Suite 106 Beverly Hills CA 9 (San Francisco) 03/07/2018 S5KG21 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
E0034 Information on Occupancy/Needs Standard
K0331 Interior Wall and Ceiling Finish Standard
K0351 Sprinkler System - Installation Standard
K0712 Fire Drills Standard
▼ 05C0002066 Premier Surgery Center Of Beverly Hills, Llc 99 N La Cienega Suite 106 Beverly Hills CA 9 (San Francisco) 02/28/2018 S5KG11 Recertification
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
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0002073 Admiralty Surgery Center, Inc 4640 Admiralty Way, Suite 718b Marina Del Rey CA 9 (San Francisco) 08/07/2019 Y9N621 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0002073 Admiralty Surgery Center, Inc 4640 Admiralty Way, Suite 718b Marina Del Rey CA 9 (San Francisco) 07/11/2019 Y9N611 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0221 NOTICE OF RIGHTS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0002082 Sea Surgery Center, Llc 770 Pacific Coast Highway, #102 Seal Beach CA 9 (San Francisco) 02/05/2018 PLXY11 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
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0002083 Genesis Ambulatory Surgery Center Inc 26781 Portola Pkwy Suite 4e Foothill Ranch CA 9 (San Francisco) 04/07/2025 65CD5-H1 Complaint
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
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 05C0002083 Genesis Ambulatory Surgery Center Inc 26781 Portola Pkwy Suite 4e Foothill Ranch CA 9 (San Francisco) 04/30/2021 EM9T11 Complaint
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
Q0240 INFECTION CONTROL Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 05C0002086 Riverside Regional Surgery Center, Inc 4234 Riverwalk Parkway, Unit 160 Riverside CA 9 (San Francisco) 11/15/2018 1D7D21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
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
K0222 Egress Doors Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 05C0002086 Riverside Regional Surgery Center, Inc 4234 Riverwalk Parkway, Unit 160 Riverside CA 9 (San Francisco) 09/19/2018 1D7D11 Recertification
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
Q0120 MEDICAL STAFF Condition
Q0140 NURSING SERVICES Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS 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
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 05C0002092 Galileo Surgery Center, Lp 5000 San Palo Road Suite #100 Atascadero CA 9 (San Francisco) 11/28/2018 3YI411 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0201 LABORATORY SERVICES Standard
Q0242 INFECTION CONTROL PROGRAM Standard