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
▼ 03C0001043 Prescott Outpatient Surgical Center, Llc 815 Ainsworth Drive Prescott AZ 9 (San Francisco) 07/02/2025 6681E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0065 PHYSICIAN EVALUATION OF RISK Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 03C0001043 Prescott Outpatient Surgical Center, Llc 815 Ainsworth Drive Prescott AZ 9 (San Francisco) 07/02/2025 6681E-L1 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
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0031 Emergency Officials Contact Information Standard
K0100 General Requirements - Other Standard
K0291 Emergency Lighting Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 03C0001043 Prescott Outpatient Surgical Center, Llc 815 Ainsworth Drive Prescott AZ 9 (San Francisco) 03/21/2019 7CK111 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
▼ 03C0001043 Prescott Outpatient Surgical Center, Llc 815 Ainsworth Drive Prescott AZ 9 (San Francisco) 03/21/2019 7CK121 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 03C0001044 Barnet Dulaney Perkins Eye Center Pc 160 West University Drive, Suite 1 Mesa AZ 9 (San Francisco) 03/16/2026 1F31B8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0042 HOSPITALIZATION Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 03C0001044 Barnet Dulaney Perkins Eye Center Pc 160 West University Drive, Suite 1 Mesa AZ 9 (San Francisco) 01/10/2020 U8CQ21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
▼ 03C0001045 Mountain View Surgery Center Of Phoenix 3131 West Peoria Avenue Phoenix AZ 9 (San Francisco) 03/14/2018 SSIW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
▼ 03C0001045 Mountain View Surgery Center Of Phoenix 3131 West Peoria Avenue Phoenix AZ 9 (San Francisco) 03/14/2018 SSIW21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 03C0001050 Southwestern Eye Center - Yuma Surgery Center 2149 West 24th Street Yuma AZ 9 (San Francisco) 09/28/2020 TJ5821 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 03C0001053 Ambulatory Surgery Center Of Tucson 1502 North Tucson Boulevard Tucson AZ 9 (San Francisco) 02/13/2024 61CF5-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard