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
▼ 03C0001352 Surgcenter Of Deer Valley, Llc 19820 North 7th Street, Suite 190 Phoenix AZ 9 (San Francisco) 04/05/2018 0YKK11 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
▼ 03C0001352 Surgcenter Of Deer Valley, Llc 19820 North 7th Street, Suite 190 Phoenix AZ 9 (San Francisco) 04/05/2018 0YKK21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 03C0001355 Surgcenter Chandler, Llc 3345 South Val Vista Drive, Suites 107-110 Gilbert AZ 9 (San Francisco) 04/14/2026 22D671-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0042 HOSPITALIZATION Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 03C0001355 Surgcenter Chandler, Llc 3345 South Val Vista Drive, Suites 107-110 Gilbert AZ 9 (San Francisco) 04/14/2026 22D671-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0013 Development of EP Policies and Procedures Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information on Occupancy/Needs Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001355 Surgcenter Chandler, Llc 3345 South Val Vista Drive, Suites 107-110 Gilbert AZ 9 (San Francisco) 09/17/2020 53BV21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001356 Mountain View Surgery Center Of Glendale 18555 North 79th Avenue, Building C Glendale AZ 9 (San Francisco) 06/24/2021 JR6Q11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 03C0001358 Tomar Pain Centers, Pllc 1821 North Trekell Road, Building A, Suite 3b Casa Grande AZ 9 (San Francisco) 12/17/2020 R5DZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
▼ 03C0001358 Tomar Pain Centers, Pllc 1821 North Trekell Road, Building A, Suite 3b Casa Grande AZ 9 (San Francisco) 12/17/2020 R5DZ21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 03C0001358 Tomar Pain Centers, Pllc 1821 North Trekell Road, Building A, Suite 3b Casa Grande AZ 9 (San Francisco) 08/27/2018 1R9L11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0020 Policies for Evac. and Primary/Alt. Comm. 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
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
▼ 03C0001358 Tomar Pain Centers, Pllc 1821 North Trekell Road, Building A, Suite 3b Casa Grande AZ 9 (San Francisco) 08/27/2018 1R9L21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0913 Electrical Systems - Wet Procedure Locations Standard